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CPT 37258: Iliac Artery Stent Placement for Straightforward Lesion

CPT code 37258 represents stent placement, with or without angioplasty, for a straightforward stenotic lesion in an initial iliac artery (common, internal, or external). It encompasses all components of the intervention, including access, catheterization, lesion crossing, and imaging guidance, and can be performed via open or percutaneous approaches. This code is important nationally because iliac artery interventions are a common element of peripheral arterial disease management and account for significant procedural volume and spending in vascular services.

Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, information on typical sites of service, and an overview of what a billing event under this code generally includes. The publication also provides benchmarking and reimbursement context, payer policy summaries where available, and related coding considerations to support billing and revenue cycle clarity.

This material is written for a national audience of clinicians, billing professionals, and policy analysts seeking a clear reference for CPT code 37258 — its clinical scope, where it is typically performed, and what topics to review for payer coverage and coding alignment.

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Billing Code Overview

CPT code 37258 describes stent placement, with or without angioplasty, for a straightforward lesion in an initial iliac artery (common, internal, or external iliac). The procedure includes all access, catheterization, lesion crossing, and imaging guidance required to complete the intervention. The approach may be open or percutaneous.

Service type: Endovascular revascularization with stent deployment (iliac artery, initial vessel, straightforward lesion)

Typical site of service: Hospital inpatient or outpatient interventional suite, or ambulatory surgical center, depending on clinical status and facility capabilities.

Data not available in the input.

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CPT 37258: Iliac Artery Stent Placement for Straightforward Lesion

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Billing Code Overview

Service type: Endovascular revascularization with stent deployment (iliac artery, initial vessel, straightforward lesion)

Typical site of service: Hospital inpatient or outpatient interventional suite, or ambulatory surgical center, depending on clinical status and facility capabilities.

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 68-year-old male with progressive right-sided claudication and an ankle-brachial index of 0.65 presents after conservative therapy failure. Noninvasive arterial imaging (duplex ultrasound and CT angiography) demonstrates a focal, straightforward atherosclerotic stenosis of the right external iliac artery prompting endovascular intervention. The patient is evaluated in the vascular surgery/vascular interventional radiology clinic, consents for stent placement with possible angioplasty, and is scheduled for a percutaneous endovascular procedure. On the day of service the patient undergoes conscious sedation in an interventional suite or hybrid operating room. Vascular access is obtained (commonly common femoral artery), diagnostic angiography is performed to localize the lesion, lesion crossing with guidewire and catheter is completed, angioplasty is performed if needed, and a stent is deployed in the iliac artery. Imaging guidance (fluoroscopy/angiography) is used throughout. Hemostasis is achieved via manual compression, closure device, or open exposure depending on access. Typical post-procedure workflow includes vascular monitoring in PACU, discharged same day or overnight observation depending on comorbidities, antiplatelet management per vascular team, and follow-up vascular imaging at 1–6 months.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when reporting only the physician interpretation/reading of vascular imaging if distinct from technical component.

59 | Distinct procedural service | Use when an unrelated, separate endovascular procedure is performed during the same session that is not typically bundled with stent placement.

51 | Multiple procedures | Use when multiple endovascular procedures (different vascular families) are performed in the same session and payer requires this modifier for multiple procedure reduction.

52 | Reduced services | Use when the procedure is partially reduced or not completed as documented (e.g., attempted but aborted deployment).

53 | Discontinued procedure | Use when procedure is started but discontinued due to extenuating circumstances prior to completion.

76 | Repeat procedure by same physician | Use when the same physician repeats the procedure later the same day.

77 | Repeat procedure by another physician | Use when a different physician repeats the procedure later the same day.

78 | Unplanned return to the operating/procedure room by the same physician following initial procedure for a related intervention (related to postoperative complication) | Use when patient requires an unplanned re-intervention in the intra/postoperative period.

79 | Unrelated procedure or service by the same physician during the postoperative period | Use when an unrelated procedure is performed during global period.

LT | Left side | Use to identify the left iliac territory when laterality is required.

RT | Right side | Use to identify the right iliac territory when laterality is required.

Taxonomy Code	Specialty	Notes
`207K00000X`	Vascular Surgery	Primary surgical specialty performing open or endovascular iliac stenting.

2080P0207X | Interventional Cardiology | May perform peripheral endovascular interventions including iliac stenting in some practices.

174400000X | Interventional Radiology | Commonly performs percutaneous iliac stent placement in the angiography suite.

207L00000X | General Surgery | Vascular-trained general surgeons may perform iliac stent placement in hybrid OR settings.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I70.219`	Atherosclerosis of native arteries of the extremities with intermittent claudication, unspecified extremity	Common indication for iliac artery stent placement when atherosclerotic stenosis causes claudication.

I70.238 | Atherosclerosis of native arteries of the extremities with rest pain, other extremity | Indicates more severe limb ischemia prompting revascularization including iliac stenting.

I70.229 | Atherosclerosis of native arteries of the extremities with ulceration, unspecified extremity | Limb-threatening ischemia with tissue loss may require iliac revascularization as part of limb salvage.

I80.2 | Phlebitis and thrombophlebitis of other deep vessels of lower extremities | Not a direct indication for arterial stenting; included for differential vascular presentations — Data not available in the input.

I74.3 | Embolism and thrombosis of arteries of lower extremities | Acute arterial occlusion may be treated endovascularly; iliac stenting may be part of management if inflow disease is present.

R54 | Age-related physical debility (often accompanying peripheral vascular disease) | Contributes to functional assessment and peri-procedural risk stratification.

E11.51 | Type 2 diabetes mellitus with diabetic peripheral angiopathy with gangrene | Diabetes increases atherosclerotic burden and risk of critical limb ischemia requiring iliac intervention.

Z95.2 | Presence of prosthetic heart valve (example comorbidity code) | Comorbidity codes are often reported for peri-procedural risk and medication considerations.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`37228`	Transcatheter placement of intravascular stent(s), open or percutaneous, including angioplasty when performed; initial additional infrainguinal arterial stent placement	Performed for infrainguinal disease; may be coded if stenting in femoropopliteal segment during same hospitalization (different vascular territory).

35476 | Insertion, non-tunneled centrally inserted central venous catheter; not otherwise specified (Note: example central venous access codes are not typically related to arterial procedures) | Data not available in the input.

36200 | Introduction of catheter, aorta, selective, for diagnostic angiography | May be performed prior to iliac stent placement for diagnostic catheterization of the aortoiliac segment.

37251 | Transcatheter therapy, percutaneous, for treatment of iliac artery disease; balloon angioplasty, each vessel | Used when balloon angioplasty of the iliac artery is performed without stent placement, or in addition to angioplasty prior to stent deployment.

36011 | Introduction of needle and/or catheter, each vessel, for diagnostic angiography, upper or lower extremity, percutaneous puncture | May be used to report access-related catheterizations when separately reportable.

76937 | Ultrasound guidance for vascular access requiring ultrasound evaluation and documentation | Often reported when ultrasound guidance is used for femoral arterial access.

G0328 | Non-invasive physiologic vascular studies, complete bilateral study | Ancillary diagnostic testing often performed pre- and post-procedure to document hemodynamic improvement.

0474T | Endovascular repair, iliac artery, with stent graft, percutaneous | Used when an iliac stent graft (endograft) is placed rather than simple bare or covered stent; different clinical scenario.

Note: If a provided list of related CPT codes had been supplied in the input, those codes would be listed here. If any related code lists are missing from the input, use clinical knowledge to include commonly associated codes.

CPT 37252: Intravascular Ultrasound for Noncoronary Vessel

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

CPT 37253: Intravascular Ultrasound for Additional Noncoronary Vessel

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

CPT 37255: Iliac Angioplasty for Additional Straightforward Lesion

CPT-37257-ILIAC-ANGIOPLASTY-COMPLEX-LESION-ADDITIONAL-VESSEL

CPT 37257: Iliac Angioplasty for Complex Lesion in Additional Vessel

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: Stent Placement in Additional Iliac Vessel During Initial Revascularization

CPT-37263-FEMORAL-POPLITEAL-ANGIOPLASTY-BALLOON

CPT 37263: Femoral and Popliteal Balloon Angioplasty

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

CPT 37264: Additional-Vessel Femoral/Popliteal Angioplasty

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

CPT 37265: Angioplasty of Complex Femoral-Popliteal Occlusive Lesion

CPT-37267-FEMORAL-POPLITEAL-STENT-PLACEMENT

CPT 37267: Femoral and Popliteal Arterial Stent Placement

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Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

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Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when reporting only the physician interpretation/reading of vascular imaging if distinct from technical component.