CPT 37243 Endovascular Embolization Reimbursement

CPT code 37243 represents an endovascular embolization procedure in which a physician intentionally partially or completely blocks blood flow to a target area to treat benign or malignant tumors (including uterine fibroids) or to induce organ ischemia or infarction. This code is used nationally for reporting image-guided vascular occlusion when embolic agents or devices are employed to achieve devascularization. The code matters because embolization is a key minimally invasive option across oncology, gynecology, and vascular therapy, with implications for utilization, facility resource planning, and payer coverage policy.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical intent and settings for the procedure, typical sites of service, and the payer landscape relevant to national coverage. The publication also summarizes common billing considerations, associated service line context, and related coding references where available. Data not available in the input is noted where relevant. This summary equips clinicians, billing staff, and policy analysts with the core facts needed to interpret and classify claims involving CPT code 37243 and to understand its role in current procedural care.

Billing Code Overview

CPT code 37243 describes a physician-performed procedure to partially or completely block vascular blood flow in a target area to treat benign or malignant tumors (including uterine fibroids), or to induce organ ischemia or infarction. This procedure is a form of endovascular embolization or occlusion performed by an interventional radiologist, vascular surgeon, or other qualified specialist.

Service type: Endovascular embolization / vascular occlusion procedure
Typical site of service: Hospital outpatient department, ambulatory surgery center, or inpatient interventional suite

Clinical Context

A 62-year-old female with a history of symptomatic uterine fibroids presents with heavy menstrual bleeding, pelvic pressure, and anemia despite medical therapy. Imaging with pelvic ultrasound and MRI confirms multiple dominant fibroids supplied by uterine arteries. The interventional radiology team evaluates the patient and schedules an outpatient uterine artery embolization (UAE) to occlude the arterial supply to the fibroids and induce ischemic shrinkage. The clinical workflow includes pre-procedure consent and review of imaging and labs, periprocedural intravenous access and moderate sedation or monitored anesthesia care, vascular access (typically common femoral artery), selective catheterization of the uterine arteries under fluoroscopic guidance, delivery of embolic agents to partially or completely block blood flow to the fibroid targets, angiographic confirmation of stasis, hemostasis of the access site, and post-procedure observation with instructions for analgesia and follow-up imaging.

A similar scenario applies when treating hepatic or renal tumors with transarterial embolization for palliation or oncologic control: a patient with a hypervascular liver metastasis or hepatocellular carcinoma undergoes pre-procedure imaging and labs, selective catheter-directed embolization of the tumor feeder vessels in an interventional radiology angiography suite, and post-procedure monitoring for ischemic complications.

Typical site of service: outpatient ambulatory surgical center or hospital-based interventional radiology angiography suite. Service type: image-guided vascular embolization/occlusion of target vessels for tumor treatment or organ devascularization.

Coding Specifications

Modifier	Description	When to Use

Taxonomy Code	Specialty	Notes
`208800000X`	Interventional Radiology	Primary specialty performing arterial embolization procedures.
`207RX0300X`	Vascular Surgery	Performs endovascular occlusion procedures for tumors or organ ischemia in some centers.
`208000000X`	Diagnostic Radiology	Radiologists performing image-guided embolization and angiography.
`333600000X`	Surgical Oncology	May collaborate for tumor-directed embolization as part of oncologic care.
`207Q00000X`	General Surgery	May be involved in hybrid or intraoperative embolization procedures.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`D25.9`	Leiomyoma of uterus, unspecified	Uterine fibroids are a primary benign indication for uterine artery embolization to reduce bleeding and bulk symptoms.
`C22.0`	Hepatocellular carcinoma	Hepatic tumor treated with transarterial embolization or chemoembolization to induce ischemia and tumor necrosis.
`C79.51`	Secondary malignant neoplasm of liver	Liver metastases may be treated with transarterial embolization for palliation or tumor control.
`N28.9`	Disorder of kidney, unspecified	Renal tumors or vascular lesions may be managed with selective embolization to devascularize lesions.
`I82.90`	Acute embolism and thrombosis of unspecified deep veins of lower extremity	Vascular occlusion procedures differ clinically; listed to consider thrombotic complications or differential vascular interventional care.
`D73.5`	Portal hypertension	Embolization procedures (e.g., variceal or porto-systemic interventions) may be part of complex hepatic vascular management.
`C56.9`	Malignant neoplasm of ovary, unspecified	Pelvic tumor embolization may be performed for pelvic malignancies causing bleeding or pain.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36247`	Selective catheter placement, arterial system; each first order thoracic, abdominal or pelvic branch, within a vascular family, including angiography when performed, and all associated radiological supervision and interpretation	Often performed immediately before embolization to access and selectively catheterize feeder vessels.
`36248`	Selective catheter placement, arterial system; second order thoracic, abdominal or pelvic branch, within a vascular family, during same session	Used for deeper selective catheterization of tumor feeders during the embolization session.
`37244`	Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, percutaneous, including fluoroscopic guidance, initial vessel	Adjacent embolization code when multiple separate vascular territories or additional vessels are embolized; used when coding multiple embolization sites.
`76937`	Ultrasound guidance for vascular access	Used when ultrasound is used to gain vascular access (e.g., femoral artery) prior to angiography and embolization.
`93010`	Electrocardiogram, routine ECG with interpretation and report	Commonly performed pre-procedure as part of anesthesia risk assessment for patients undergoing sedation or monitored anesthesia care.

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Summary & Overview

CPT 37243: Endovascular Embolization for Tumors or Ischemia