CPT 37238 Venous Stent Placement Reimbursement | OpenPayer

Summary & Overview

CPT 37238: Venous Stent Placement via Catheter

CPT code 37238 denotes endovascular stent placement in a vein via catheter, performed with either percutaneous or open access and inclusive of radiological supervision and interpretation. This procedure is a key component of venous intervention for conditions such as central venous stenosis, venous outflow obstruction, or occlusive disease that require mechanical luminal support. Nationally, venous stent placement is significant because it affects hospital resource use, interventional radiology and vascular surgery practice patterns, and payer coverage policies for endovascular therapy.

Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical and billing profile of CPT code 37238, including the service type and typical sites of service, common modifiers listed in the input, and how the code fits into vascular interventional care pathways. The publication summarizes benchmark considerations, coding context, and policy-relevant elements for national payers and providers. Data not available in the input will be explicitly noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 37238venous stentvascular interventioninterventional radiologyambulatory surgeryhospital outpatientprocedure codingendovascular

Billing Code Overview

CPT code 37238 describes the insertion of an intravascular stent in a vein using catheter-based techniques. The procedure may be performed with either open surgical access or percutaneous access, and includes radiological supervision and interpretation as part of the service.

Service type: Vascular interventional procedure (venous stent placement)
Typical site of service: Hospital outpatient department, inpatient operating room, or interventional radiology suite (ambulatory surgical centers may also perform percutaneous venous stent placements)

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 68-year-old male with end-stage renal disease on hemodialysis presents with progressive swelling of the ipsilateral arm and poor dialysis circuit flow. Duplex ultrasound and fistulogram demonstrate a significant central venous stenosis of the right subclavian vein near the dialysis catheter exit site with limited flow through the arteriovenous fistula. The vascular interventional team plans a percutaneous transluminal venous stent placement to restore central venous patency.

The clinical workflow includes pre-procedure assessment (history, anticoagulation review, informed consent), imaging guidance (fluoroscopy with contrast venography), venous access (percutaneous or open), lesion crossing with guidewire, balloon angioplasty followed by deployment of a self-expanding or balloon-expandable venous stent across the stenotic segment, post-deployment venography to confirm flow and stent apposition, hemostasis at access site, and post-procedure monitoring for complications such as bleeding, access-site hematoma, stent migration, or contrast reaction. Radiological supervision and interpretation are included as part of the procedure coding.

Coding Specifications

Modifier	Description	When to Use
`11`	Normal or routine service	When the service is the standard for the encounter with no unusual circumstances

CPT 37236: Arterial Stent Placement, Endovascular

CPT-37279-FEMORAL-POPLITEAL-INTRAVASCULAR-LITHOTRIPSY

CPT 37279: Intravascular Lithotripsy During Femoral/Popliteal Revascularization

CPT-37239-SECONDARY-VENOUS-STENT-INSERTION-ENDOVASCULAR

CPT 37239: Secondary Venous Stent Insertion, Endovascular

CPT-37275-ATHERECTOMY-STENT-FEMORAL-POPLITEAL

CPT 37275: Atherectomy with Stent Placement, Femoral/Popliteal

CPT-37277-ATHERECTOMY-STENT-FEMORAL-POPLITEAL-OCCLUSION

CPT 37277: Atherectomy and Stent Placement for Femoral–Popliteal Occlusion

CPT-37237-ADD-ON-ENDOVASCULAR-STENT-PLACEMENT

CPT 37237: Add-On Endovascular Arterial Stent Placement

CPT-37247-TRANSLUMINAL-BALLOON-ANGIOPLASTY-ADDITIONAL-ARTERIES

CPT 37247: Transluminal Balloon Angioplasty, Additional Arteries

CPT-37268-FEMORAL-POPLITEAL-ADDITIONAL-VESSEL-STENT-PLACEMENT

CPT 37268: Additional Femoral/Popliteal Vessel Stent Placement During Same Session

CPT-37254-ILIAC-ARTERY-ANGIOPLASTY-BALLOON-DILATION

CPT 37254: Iliac Artery Angioplasty (Balloon Dilation)

CPT-37281-TIBIAL-PERONEAL-ANGIOPLASTY-ADDITIONAL-VESSEL

CPT 37281: Angioplasty of Additional Tibial/Peroneal Vessel

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Taxonomy Code	Specialty	Notes
207Q00000X	Vascular Surgery	Vascular surgeons commonly perform venous stent placement, open or percutaneous access
207P00000X	Interventional Cardiology	Interventional cardiologists may treat central venous stenosis using endovascular stent techniques
2083P0002X	Interventional Radiology	Interventional radiologists frequently perform percutaneous venous stent placement under fluoroscopic guidance
207L00000X	General Surgery	General surgeons with endovascular training may perform these procedures
208U00000X	Diagnostic Radiology	Diagnostic radiologists with interventional privileges may provide supervision and interpretation

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I87.1`	Venous insufficiency (chronic)	Chronic venous outflow obstruction can contribute to central venous stenosis and need for stenting
`I80.89`	Phlebitis and thrombophlebitis of other sites	Prior thrombotic events may lead to venous scarring and stenosis requiring stent placement
`I82.401`	Acute embolism and thrombosis of unspecified deep veins of right lower extremity	DVT history may lead to chronic post-thrombotic venous obstruction treated with stenting
`I82.402`	Acute embolism and thrombosis of unspecified deep veins of left lower extremity	As above, for left-sided presentations
`T82.7XXA`	Stenosis of vascular graft, initial encounter	Stenosis of dialysis grafts or related devices frequently necessitates endovascular stent placement
`N18.6`	End stage renal disease	ESRD patients on hemodialysis commonly develop central venous stenosis from prior catheters and require venous stenting
`Z45.2`	Encounter for adjustment and management of vascular dialysis catheter	Dysfunctional dialysis catheters and associated central venous stenosis often prompt stent placement
`I96`	Gangrene, not elsewhere classified	Severe chronic venous insufficiency and compromised perfusion can be associated findings in advanced cases

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36011`	Introduction of catheter, venous, central, for diagnostic purposes; percutaneous, without subcutaneous port or pump, each catheter	Venous access and diagnostic central venous catheter placement may precede stent placement for venography or temporary access
`35476`	Transcatheter placement of intravascular stent(s), open or percutaneous, iliac artery, including radiological supervision and interpretation	While arterial, similar technique codes describe stent deployment; referenced for procedural parallels (note: arterial CPTs are analogous; venous-specific code is `37238`)
`37235`	Transcatheter placement of intravascular stent(s), including radiological supervision and interpretation; initial peripheral artery or branch, open or percutaneous	Balloon angioplasty or adjunctive arterial stenting codes are often performed in the same suite when treating concomitant arterial lesions
`36247`	Selective catheter placement, arterial system; each first order thoracic, abdominal, or lower extremity branch, radiological supervision and interpretation	Diagnostic angiography codes may be used for selective venography when imaging upstream or collateral vessels
`36010`	Introduction of needle or catheter into central vein; central venous cannulation, without imaging	Performed when central venous access is obtained to facilitate the endovascular approach

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