Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.30
    OpenPayerBilling CodesIntravascular Ultrasound Procedures on Arteries and VeinsCPT cpt-37257-iliac-angioplasty-complex-lesion-additional-vessel
    Ask Trek AI about this page

    CPT 37257: Angioplasty of Additional Complex Iliac Lesion

    Medicare pays $599 on average nationally for this procedure.

    CPT code 37257 describes angioplasty (balloon dilation) of a complex iliac artery lesion (complete occlusion) performed during the same session as an initial iliac revascularization; the service includes all access, catheterization, lesion crossing, and imaging guidance and may be performed via an open or percutaneous approach, classifying the service type as an adjunct iliac angioplasty for complex occlusive lesions with a typical site of service in the endovascular/interventional radiology or vascular surgery setting (hospital-based or specialized outpatient vascular centers).

    For related coverage guidance, see recent payer policy updates: Automated Ambulatory Blood Pressure Monitoring for Diagnosis of Hypertension in Patients with Elevated Office Blood Pressure, Cardiology - Ivabradine, Cardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA).

    Customize your policy alerts

    Sign up for cpt 37257 policy alerts

    Get alerted when payer policies referencing 37257 are released or updated.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Table of contents

    Progress1 / 7

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • Facility ComparisonBeds, revenue & payer mix
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Clinical & Coding Specifications

    Clinical Context

    A 72-year-old man with a history of peripheral arterial disease, hypertension, and smoking presents with worsening right lower-extremity claudication and diminished ankle-brachial index. Noninvasive testing and CT angiography show a significant stenosis in the right common iliac artery and a separate chronic total occlusion of the ipsilateral external iliac artery. The vascular interventional team plans an initial iliac revascularization service with stent placement to treat the primary lesion. During the same operative session, after establishing vascular access and performing angiography, the interventionalist performs balloon angioplasty of the additional complex occluded iliac vessel to restore inline flow.

    The clinical workflow includes pre-procedure evaluation and informed consent, vascular access (percutaneous or open), diagnostic angiography, lesion crossing techniques for the occluded segment, balloon angioplasty of the additional complex lesion, adjunctive imaging (fluoroscopy and digital subtraction angiography), hemostasis, and post-procedure monitoring in a recovery area or vascular observation unit. Typical personnel include an interventional vascular surgeon or interventional radiologist, technologists, nursing staff, and anesthesia as required. Typical sites of service are hospital inpatient, hospital outpatient (ambulatory surgery center within hospital), or freestanding ambulatory surgical center, depending on patient comorbidities and institutional capabilities.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    37254Transcatheter placement of intravascular stent(s), iliac artery, unilateral, with angioplasty when performed; initial vesselOften reported for the primary iliac stent placement during the same session; 37257 is reported for angioplasty of an additional complex occluded iliac vessel at the same session.

    | 37258 | Transcatheter placement of intravascular stent(s), iliac artery, bilateral, with angioplasty when performed; initial vessel(s) | Used when bilateral iliac stenting is performed; may be part of the overall iliac revascularization strategy.

    | 36011 | Introduction of needle or intracatheter, arterial, for diagnostic purposes, without radiological supervision and interpretation, not elsewhere classified | Represents arterial access techniques; diagnostic arterial access and catheter placement are components of iliac interventions and may be reported when separately payable per payer rules.

    | 93580 | Catheter introduction for diagnostic angiography, peripheral arterial, with imaging supervision and interpretation; iliac/celiac/mesenteric or extremity vessels | Represents diagnostic peripheral angiography of the iliac vessels that commonly precedes therapeutic iliac angioplasty/stenting.

    | 37246 | Revascularization, endovascular, open or percutaneous, including angioplasty, atherectomy, and/or stent, any vascular family, initial vessel | May be used in some coding scenarios for peripheral endovascular revascularization when code sets are grouped; selection depends on exact vessel and payer guidance.

    | 76937 | Ultrasound guidance for vascular access | Used when ultrasound guidance is employed for vascular access during percutaneous iliac interventions.

    | 36415 | Collection of venous blood by venipuncture | Represents common ancillary services for pre- and intra-procedural labs; billed separately when applicable.

    | 99024 | Postoperative follow-up visit, during a global period, related to the original procedure | Used for routine post-op visits during the global period; documentation must support routine nature.

    | 92973 | Transcatheter therapy, not otherwise specified (for noncoronary vascular beds) | Rarely used; include only per coding guidance when no specific code applies.

    | 77012 | Computed tomography guidance for diagnostic, surveillance, or therapeutic procedures (list separately in addition to primary procedure) | Used when CT guidance is used for lesion localization or crossing adjunctively during complex iliac interventions.

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    25CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    208100000X
    207L00000X
    2086S0122X
    2084B0002X
    207RT0003X
    207XS0106X
    152WP0200X
    2084P0005X

    Related ICD-10-CM Codes

    27 rows

    ICD-10-CM CodeDescription
    I70.201Unspecified atherosclerosis of native arteries of extremities, right leg
    I70.202Unspecified atherosclerosis of native arteries of extremities, left leg
    I70.203Unspecified atherosclerosis of native arteries of extremities, bilateral legs
    I70.208Unspecified atherosclerosis of native arteries of extremities, other extremity
    I70.209Unspecified atherosclerosis of native arteries of extremities, unspecified extremity
    I70.211Atherosclerosis of native arteries of extremities with intermittent claudication, right leg
    I70.212Atherosclerosis of native arteries of extremities with intermittent claudication, left leg
    I70.213Atherosclerosis of native arteries of extremities with intermittent claudication, bilateral legs
    I70.218Atherosclerosis of native arteries of extremities with intermittent claudication, other extremity
    I70.219Atherosclerosis of native arteries of extremities with intermittent claudication, unspecified extremity

    Showing 1–10 of 27

    Related Payer Policy Updates

    Specialty: Cardiology1 / 3

    10 rows

    PolicyPayerEffective Date
    Automated Ambulatory Blood Pressure Monitoring for Diagnosis of Hypertension in Patients with Elevated Office Blood PressureBluecross Idaho2026-11-01
    Cardiology - IvabradineCigna2026-10-15
    Cardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA)univerahealthcare2026-10-15
    Percutaneous Ventricular Assist DeviceUnitedHealthcare2026-10-01
    Cardiovascular Disease Risk AssessmentOscar Health2026-10-01
    Biomarkers for Myocardial Infarction and Chronic Heart FailureOscar Health2026-10-01
    Multiple Procedure Payment Reduction for Diagnostic Cardiovascular ProceduresBlue Cross Blue Shield - Maine2026-10-01
    Left Atrial Appendage Closure Devicesexcellus_health_plan_inc2026-09-17
    Left Atrial Appendage Closure Devicesuniverahealthcare2026-09-17
    Cardiac Omnibus CodesCigna2026-09-15

    Related Codes

    CPT-37252-INTRAVASCULAR-ULTRASOUND-NONCORONARY-VESSEL

    CPT 37252: Intravascular Ultrasound for Noncoronary Vessel, First Vessel

    CPT-37253-INTRAVASCULAR-ULTRASOUND-NONCORONARY-ADD-ON

    CPT 37253: Intravascular Ultrasound, Noncoronary Vessel, Add-On

    CPT-37255-ILIAC-ANGIOPLASTY-ADD-ON-LESION

    CPT 37255: Angioplasty of Additional Iliac Vessel

    CPT-37258-ILIAC-ARTERY-STENT-PLACEMENT-INITIAL-VESSEL-STRAIGHTFORWARD-LESION

    CPT 37258: Iliac Artery Stent Placement, Initial Lesion

    CPT-37260-ILIAC-ARTERY-STENT-PLACEMENT-COMPLETE-OCCLUSION

    CPT 37260: Iliac Artery Stent Placement for Occlusive Lesion

    CPT-37261-ILIAC-STENT-PLACEMENT-ADDITIONAL-VESSEL

    CPT 37261: Iliac Stent Placement for Additional Occluded Vessel

    CPT-37263-FEMORAL-POPLITEAL-ANGIOPLASTY-BALLOON

    CPT 37263: Femoral and Popliteal Angioplasty, Simple Lesion

    CPT-37264-FEMORAL-POPLITEAL-ADDITIONAL-VESSEL-ANGIOPLASTY

    CPT 37264: Angioplasty of Additional Femoral/Popliteal Vessel

    CPT-37265-FEMORAL-POPLITEAL-COMPLEX-LESION-ANGIOPLASTY

    CPT 37265: Angioplasty for Complex Femoral/Popliteal Occlusion

    CPT-37267-FEMORAL-POPLITEAL-STENT-PLACEMENT

    CPT 37267: Femoral and Popliteal Artery Stent Placement

    Showing 1–10 of 32

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
    Published by

    Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.