Summary & Overview
CPT 37254: Iliac Artery Angioplasty (Balloon Dilation)
CPT code 37254 denotes angioplasty (balloon dilation) of a straightforward stenotic lesion in an initial iliac artery (common, internal, or external iliac). This code captures the full procedural bundle: vascular access, catheter-based navigation, lesion crossing, and imaging guidance. Nationally, iliac angioplasty is a common endovascular intervention for symptomatic peripheral arterial disease and limb ischemia; accurate coding under 37254 is important for clinical reporting, utilization tracking, and payer coverage determinations.
Key payers in the review include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical and billing overview of the procedure, typical sites of service, and the core elements embodied in the code. The publication summarizes common coding relationships and related service-line considerations, highlights typical payer coverage patterns and prior authorization tendencies at a national level, and provides benchmarks and policy-relevant context where available. The aim is to equip clinicians, coders, and administrators with a clear understanding of what 37254 represents, why it matters for case selection and resource planning, and which documentation elements support appropriate code assignment.
Data not available in the input: specific modifiers, associated taxonomies, ICD-10 diagnosis examples, payer-specific fee schedules, and related CPT codes.
Billing Code Overview
CPT code 37254 describes percutaneous or open angioplasty (balloon dilation) of a straightforward stenotic lesion in an initial iliac artery (common, internal, or external iliac artery). The procedure includes vascular access, catheterization, lesion crossing, and imaging guidance necessary to complete the angioplasty.
Service type: Endovascular peripheral arterial intervention (angioplasty) for iliac artery stenosis
Typical site of service: Hospital outpatient department or ambulatory surgery center; may also be performed in an interventional radiology or vascular surgery suite
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with progressive left calf claudication and diminished femoral and distal pulses is evaluated for peripheral arterial disease. Noninvasive testing (ABI, duplex ultrasound) demonstrates a significant stenosis of the left common iliac artery. After risk assessment and informed consent, the patient is scheduled to the interventional suite for percutaneous transluminal angioplasty of the iliac artery. The clinical workflow includes pre-procedure evaluation (history, medications, anticoagulation management), vascular access (usually common femoral artery puncture), diagnostic angiography to confirm lesion location and morphology, crossing the stenosis with guidewires, balloon angioplasty of the target iliac lesion (37254) under fluoroscopic imaging, intraprocedural hemodynamic and angiographic assessment, possible adjunctive stenting if required (not included in 37254), hemostasis/closure device application, post-procedure monitoring for access site complications, and discharge planning with antiplatelet therapy and follow-up imaging or vascular clinic visits.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the physician’s professional interpretation when separate from technical services (rare for endovascular procedures). |