CPT 37246 Percutaneous Balloon Angioplasty Reimbursement | OpenPayer

Summary & Overview

CPT 37246: Percutaneous Balloon Angioplasty of an Artery

CPT code 37246 denotes percutaneous transluminal balloon angioplasty of an artery performed via open incision or percutaneous access, with inclusion of all imaging guidance and radiological supervision and interpretation. The code excludes procedures on the dialysis circuit, lower extremity, intracranial, coronary, and pulmonary arteries. This code is nationally relevant because angioplasty remains a common, image-guided treatment for arterial stenosis and occlusion across hospital inpatient and outpatient settings, with implications for payer coverage, prior authorization workflows, and clinical care pathways. Key payers analyzed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will find a concise overview of the clinical service represented by CPT code 37246, common sites of service, and the procedural scope as defined by the CPT descriptor. The publication summarizes payer coverage considerations and benchmarking context, highlights coding and billing boundaries (noting explicit arterial territories excluded by the descriptor), and provides operational context for radiology, vascular surgery, and interventional cardiology stakeholders. Data limitations: Associated taxonomies, specific ICD-10 diagnosis links, and related codes are not provided in the input and are noted as unavailable where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare37246CPTangioplastypercutaneousendovascularinterventional-radiologyarterial-revascularizationimage-guided-procedure

Billing Code Overview

CPT code 37246 describes percutaneous transluminal angioplasty of an artery using a balloon-tipped catheter introduced by an open incision or percutaneous access. The procedure involves inflating the balloon as many times and at as many points as necessary within the same artery to restore or improve arterial blood flow. The CPT descriptor specifies inclusion of all imaging guidance and diagnostic imaging required to perform the angioplasty, as well as radiological supervision and interpretation (RS&I).

Service type: Endovascular peripheral angioplasty procedure performed via open or percutaneous arterial access.

Typical site of service: Hospital inpatient or outpatient vascular/interventional radiology suite or catheterization laboratory where image-guided arterial interventions are performed.

Data not available in the input for Associated Taxonomies, ICD-10 Diagnoses, and Related Codes.

Clinical & Coding Specifications

Clinical Context

A 68-year-old patient with a history of peripheral arterial disease (PAD), hypertension, hyperlipidemia, and intermittent claudication presents with progressive exertional leg pain and an ankle-brachial index (ABI) of 0.6 in the affected limb. Noninvasive testing (Duplex ultrasound and/or CTA) demonstrates a focal stenotic lesion of a peripheral upper extremity or visceral artery (excluding lower extremity, dialysis circuit, intracranial, coronary, and pulmonary arteries). The vascular interventionalist obtains informed consent and schedules an outpatient endovascular procedure in an angiography suite or interventional radiology operating room.

On the day of service, the patient arrives fasting, receives moderate sedation per institutional protocols, and is positioned for arterial access (commonly femoral or brachial). Under sterile technique the provider performs percutaneous arterial access, advances a guidewire and catheter under fluoroscopic imaging to the target artery, and performs angiography to localize the lesion. A balloon-tipped catheter is placed into the arterial lumen and the balloon is inflated as many times and at as many points as necessary to restore vessel patency. Imaging guidance and radiological supervision and interpretation (RS&I) are performed throughout. Hemostasis is achieved at the access site, and the patient is monitored in recovery with postprocedure instructions and follow-up arranged for vascular assessment and antiplatelet management.

Typical site of service: hospital outpatient angiography suite, ambulatory surgery center, or interventional radiology suite. Service type: percutaneous transluminal angioplasty of a noncoronary, nonpulmonary, nonintracranial, non-dialysis, non-lower-extremity arterial target.

Coding Specifications

Modifier	Description	When to Use

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

CPT-37256-ILIAC-ARTERY-COMPLEX-LESION-ANGIOPLASTY

CPT 37256: Angioplasty for Complex Iliac Artery Occlusion

CPT-37249-PERIPHERAL-VEIN-BALLOON-ANGIOPLASTY-ADDITIONAL-VEINS

CPT 37249: Peripheral Vein Balloon Angioplasty, Additional Veins

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

CPT 37239: Secondary Venous Stent Insertion, Endovascular

CPT-37262-ILIAC-INTRAVASCULAR-LITHOTRIPSY-DURING-REVASCULARIZATION

CPT 37262: Intravascular Lithotripsy During Iliac Revascularization

CPT-37282-TIBIAL-PERONEAL-ANGIOPLASTY-COMPLEX-OCCLUSION

CPT 37282: Angioplasty of Complex Tibial/Peroneal Occlusion

CPT-37294-TIBIAL-PERONEAL-STENT-AND-ATHERECTOMY-REVASCULARIZATION

CPT 37294: Tibial/Peroneal Revascularization with Stent and Atherectomy

CPT-37273-FEMORAL-POPLITEAL-ATHERECTOMY-OCCLUSION

CPT 37273: Atherectomy for Femoral-Popliteal Occlusion

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)

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Taxonomy Code	Specialty	Notes
`207K00000X`	Vascular Surgery	Primary specialty performing peripheral arterial angioplasty
`207RP1001X`	Interventional Radiology	Common provider for image-guided angioplasty and RS&I
`208000000X`	Cardiovascular Disease (Interventional)	May perform noncoronary peripheral interventions in some settings
`207RH0002X`	Surgery - Cardiothoracic (Thoracic & Cardiac Surgery)	May be involved for complex multiteam cases

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I70.209`	Atherosclerosis of native arteries of the extremities, unspecified extremity, unspecified stage	Peripheral atherosclerotic stenosis causing ischemic symptoms treated with angioplasty
`I70.219`	Atherosclerosis of native arteries of the extremities, unspecified extremity, with intermittent claudication	Typical indication for peripheral angioplasty to improve claudication
`I74.3`	Embolism and thrombosis of arteries of the lower extremity	When embolic or thrombotic occlusion requires mechanical or balloon intervention
`I77.1`	Stricture of artery	Focal arterial narrowing amenable to balloon dilatation
`K55.0`	Acute vascular disorders of intestine (e.g., mesenteric ischemia)	Mesenteric arterial stenosis may be treated with percutaneous angioplasty
`I65.2`	Occlusion and stenosis of carotid artery	Selected extracranial carotid stenoses may receive endovascular interventions (not intracranial)
`I72.3`	Aneurysm of artery of upper extremity	Adjunct interventions during endovascular repair or to treat associated stenosis

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36247`	Introduction of catheter, arterial system, radiological supervision and interpretation (for diagnostic angiography)	Diagnostic angiography often precedes angioplasty to define lesion anatomy and guide intervention
`37241`	Transcatheter placement of an intraluminal stent(s), open or percutaneous, any vessel of the upper extremity (percutaneous)	Stent placement may be performed if angioplasty alone is insufficient to maintain patency
`35476`	Thrombolytic therapy, transcatheter; infusion for thrombolysis, initial 24-hour infusion	Used when thrombus is present and catheter-directed thrombolysis is required before or with angioplasty
`36011`	Introduction of non-tunneled vascular catheter; percutaneous, central venous (e.g., for arterial pressure monitoring or infusion)	Central access codes may be used when additional vascular access is needed during complex procedures
`99070`	Supplies and materials (e.g., drugs, sutures, supplies) used during the procedure, unlisted items	Billed by some facilities for disposable supplies directly related to the procedure

`11`	Primary procedure	When this angioplasty is the primary service performed during the encounter
`22`	Increased procedural services	When work or effort substantially exceeds the typical service (document specific reasons)
`23`	Unusual anesthesia	When general anesthesia is medically necessary and unusual for the procedure
`52`	Reduced services	When the procedure is partially reduced or not fully completed (document reason)
`53`	Discontinued procedure	When the procedure is terminated due to extenuating circumstances or patient instability
`59`	Distinct procedural service	When another procedure not normally reported together is performed at a separate site or session
`62`	Two surgeons	When two surgeons from different specialties perform distinct portions of the operation
`78`	Unplanned return to OR	For a return to the operating room related to the initial procedure during the global period
`79`	Unrelated procedure or service by same physician during postoperative period	When an unrelated procedure is done during the global period (not in initial list but commonly used in context)
`LT`	Left side	To indicate left-sided procedure when laterality is required by payer
`RT`	Right side	To indicate right-sided procedure when laterality is required by payer
`QX`	CRNA service with medical direction by physician	When a CRNA provides anesthesia under physician medical direction
`QK`	Medical direction of 2–4 concurrent anesthesia procedures	When the physician directs multiple concurrent anesthetics