Summary & Overview
CPT 37259: Iliac Artery Stent Placement, Additional Vessel
CPT code 37259 represents stent placement in an additional iliac artery performed during the same session as an initial iliac revascularization. The code captures deployment of a mesh stent, with or without adjunctive angioplasty, for a straightforward iliac lesion and includes all access, catheterization, lesion crossing, and imaging guidance. Nationally, this code matters because iliac revascularization and staged or multitarget endovascular treatments are common in vascular surgery and interventional radiology, affecting procedural coding, bundling, and payment determinations across public and commercial payers.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of what the code represents clinically, expected sites of service, and the service type. The publication also provides benchmarks and comparative policy context where available, guidance on common billing considerations for same-session additional-vessel stenting, and links to related procedure groupings. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 37259 describes placement of a stent in an additional iliac artery during the same session as an initial iliac revascularization. The procedure covers deployment of a stent, with or without angioplasty, for a straightforward lesion (stenosis) in the iliac vascular territory, which includes the common iliac, internal iliac, and external iliac arteries. The service includes all access, catheterization, lesion crossing, and imaging guidance necessary to complete the procedure. The approach may be open or percutaneous.
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Service type: Vascular stent placement for an additional ipsilateral or contralateral iliac artery performed during the same session as initial iliac revascularization.
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Typical site of service: Hospital-based or outpatient surgical setting, including endovascular or hybrid operating rooms; procedure may be performed percutaneously or via open access.
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with a history of smoking, hypertension, and peripheral arterial disease presents with lifestyle-limiting claudication of the left lower extremity. Noninvasive vascular studies and CTA demonstrate a focal, hemodynamically significant, atherosclerotic stenosis in the left external iliac artery in addition to a recently treated ipsilateral common iliac lesion during the same operative session. The interventional vascular surgeon performs percutaneous access in the common femoral artery under ultrasound guidance, conducts diagnostic angiography, crosses the additional external iliac lesion with a guidewire, performs balloon angioplasty for lesion preparation, and deploys a self-expanding stent in the additional iliac vessel using fluoroscopic imaging and intraprocedural contrast. Hemostasis is achieved with manual compression and/or closure device prior to recovery. The procedure includes all access, catheterization, lesion crossing, and imaging guidance required to complete the stent placement in the additional iliac vessel within the same session as the initial iliac revascularization.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the physician’s interpretation component separate from technical services (rare for endovascular procedures billed as global services). |