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CPT 37261: Stent Placement in Additional Iliac Vessel During Initial Revascularization

CPT code 37261 denotes stent placement (with or without angioplasty) in an additional iliac artery performed during the same session as an initial iliac revascularization for a complex lesion such as a complete occlusion. This code captures the work and resources required to treat an additional lesion in the iliac vascular territory (common, internal, or external iliac arteries) and includes all necessary access, catheterization, lesion crossing, and imaging guidance. Nationally, procedures addressing peripheral arterial occlusive disease are common drivers of vascular surgery and interventional radiology service lines, making accurate coding and payment for adjunctive stent placement clinically and financially important.

Payers covered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical context and service configuration for 37261, plus what to expect in payer coverage patterns, typical sites of service, and benchmarking considerations. The publication also highlights related coding considerations and common service-line implications for hospitals and ambulatory surgery centers. Data not available in the input is noted where specific payer policies, modifiers, taxonomies, ICD-10 pairings, and related codes would normally appear.

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Billing Code Overview

CPT code 37261 describes placement of a stent (and any needed angioplasty) in an additional iliac artery during the same session as an initial iliac revascularization. The procedure addresses a complex lesion such as a complete occlusion 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 required to complete the stent deployment. The approach may be open or percutaneous, and the procedure is performed during the same operative session as the initial iliac revascularization.

Service type: Vascular stent placement for an additional iliac vessel during the same session as initial iliac revascularization

Typical site of service: Hospital operating room or endovascular suite (inpatient or outpatient), or interventional radiology/catheterization lab

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CPT 37261: Stent Placement in Additional Iliac Vessel During Initial Revascularization

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Get alerted when payer policies referencing 37261 are released or updated.

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Billing Code Overview

Service type: Vascular stent placement for an additional iliac vessel during the same session as initial iliac revascularization

Typical site of service: Hospital operating room or endovascular suite (inpatient or outpatient), or interventional radiology/catheterization lab

Clinical & Coding Specifications

Clinical Context

A typical patient is a 68-year-old smoker with progressive, lifestyle-limiting left lower-extremity claudication and decreased ankle-brachial index consistent with peripheral arterial disease. Noninvasive testing (ABI, duplex ultrasound, or CT angiography) demonstrates high-grade stenosis or chronic total occlusion of an additional iliac artery segment after an index iliac intervention in the same session. The vascular surgeon or interventional radiologist performs 37261 during the same operative setting as an initial iliac revascularization to place a stent (with or without angioplasty) in the additional iliac vessel to restore inline flow.

The clinical workflow includes pre-procedure evaluation (review of imaging and antiplatelet status), informed consent, vascular access (typically common femoral or contralateral femoral with crossover technique), catheter-based angiography with imaging guidance, lesion crossing with guidewires/balloons, stent deployment to treat the complex lesion or occlusion, post-deployment angioplasty as needed, and completion angiography. Hemostasis and post-procedure monitoring follow standard endovascular protocols. Typical sites of service are the hospital operating room or catheterization/interventional radiology suite during the same session as the initial iliac procedure.

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable evaluation and management service by the same physician on the day of a procedure	Use when a distinct E/M visit is performed the same day as `37261` and documentation supports a separate E/M.
`51`	Multiple procedures	Use when `37261` is reported with other unrelated procedural codes in the same session and payer requires a multiple-procedure indicator.
`59`	Distinct procedural service	Use when another procedure performed in the same session is distinct and not bundled with `37261` to indicate separate service.
`76`	Repeat procedure by same physician	Use when the same procedure is repeated during the same session (e.g., additional stent placement attempt) and documentation supports repetition.
`77`	Repeat procedure by another physician	Use when a different physician repeats the procedure in the same session.
`78`	Return to OR for related procedure during postoperative period	Use if patient returns to the operating room in the global period for a related complication or continuation of care.
`79`	Unrelated procedure or service by the same physician during the postoperative period	Use when an unrelated procedure is performed during the global period.
`CG`	Inpatient/outpatient	Use when payer requires condition-specific inpatient/outpatient modifier (carrier-specific; verify payer rules).
`XE`	Separate encounter, different encounter	Use when the additional stent placement meets distinct encounter criteria under modifier `59` hierarchy.
`XS`	Separate structure	Use when the stented vessel is a separate anatomic site distinct from the initial treated vessel and documentation supports it.
`XP`	Separate practitioner	Use when a different practitioner performs the additional stent placement.

Taxonomy Code	Specialty	Notes
207P00000X	Vascular Surgery	Common provider specialty performing iliac stenting and complex iliac revascularization.
207RC0000X	Interventional Cardiology	Performs peripheral endovascular interventions in some settings.
2080P0207X	Interventional Radiology	Frequently performs iliac arterial stent placement under imaging guidance.
207K00000X	General Surgery	Vascular-focused general surgeons may perform these procedures.
363L00000X	Physician Assistant	May assist or perform under supervision depending on state law and payer policy.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I70.213`	Atherosclerosis of native arteries of right leg with intermittent claudication	A common indication for iliac stenting to relieve claudication from iliac atherosclerotic disease.
`I70.212`	Atherosclerosis of native arteries of left leg with intermittent claudication	Same clinical relevance for left-sided iliac lesions leading to stent placement.
`I70.233`	Atherosclerosis of native arteries of right leg with ulceration	Complex peripheral disease with tissue loss may prompt revascularization including iliac stenting.
`I70.231`	Atherosclerosis of native arteries of right leg with rest pain	Rest pain from limb ischemia is an indication for urgent revascularization.
`I74.3`	Embolism and thrombosis of arteries of lower extremities	Acute embolic or thrombotic occlusion of an iliac vessel may require endovascular recanalization and stenting.
`I70.24`	Atherosclerosis of autologous vein bypass graft of the leg with intermittent claudication	Lesions in bypass graft inflow/outflow territories occasionally necessitate iliac intervention.
`K55.1`	Chronic mesenteric ischemia (included cautiously)	Rarely, complex aortoiliac disease affecting inflow to visceral circulation can intersect with iliac procedures.
`R65.21`	Severe sepsis with septic shock (not typical)	Included only when systemic conditions complicate revascularization decisions; uncommon direct indication.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`37220`	Revascularization, endovascular, open or percutaneous, femoral-popliteal, with transluminal angioplasty	May be performed in the same session for concomitant femoropopliteal disease; complementary peripheral angioplasty.
`37224`	Revascularization, endovascular, femoral-popliteal, with stent placement	Performed when stenting is required in femoropopliteal segment during the same treatment episode.
`75956`	Angiography, vascular, noncoronary, for transcatheter placement; initial vessel	Diagnostic angiography and guidance imaging that may be performed to define lesion anatomy prior to `37261`.
`36247`	Selective catheter placement, arterial catheterization, extremity (eg, iliac)	Can be performed as part of access and catheterization steps supporting `37261` (if reported separately by some payers).
`37262`	At the same session as an initial iliac revascularization service, additional stent in another ipsilateral or contralateral lesion (note: payers have distinct rules)	Closely related code used for additional or subsequent iliac stent placements in the same session depending on lesion count and payer policy.

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

CPT 37258: Iliac Artery Stent Placement for Straightforward Lesion

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

CPT 37260: Iliac Artery Stent Placement for Occlusive Lesion

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

Showing 1–10 of 32

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.

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.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable evaluation and management service by the same physician on the day of a procedure	Use when a distinct E/M visit is performed the same day as `37261` and documentation supports a separate E/M.
`51`	Multiple procedures	Use when `37261` is reported with other unrelated procedural codes in the same session and payer requires a multiple-procedure indicator.
`59`	Distinct procedural service	Use when another procedure performed in the same session is distinct and not bundled with `37261` to indicate separate service.
`76`	Repeat procedure by same physician	Use when the same procedure is repeated during the same session (e.g., additional stent placement attempt) and documentation supports repetition.
`77`	Repeat procedure by another physician	Use when a different physician repeats the procedure in the same session.
`78`	Return to OR for related procedure during postoperative period	Use if patient returns to the operating room in the global period for a related complication or continuation of care.
`79`	Unrelated procedure or service by the same physician during the postoperative period	Use when an unrelated procedure is performed during the global period.
`CG`	Inpatient/outpatient	Use when payer requires condition-specific inpatient/outpatient modifier (carrier-specific; verify payer rules).
`XE`	Separate encounter, different encounter	Use when the additional stent placement meets distinct encounter criteria under modifier `59` hierarchy.
`XS`	Separate structure	Use when the stented vessel is a separate anatomic site distinct from the initial treated vessel and documentation supports it.
`XP`	Separate practitioner	Use when a different practitioner performs the additional stent placement.

Taxonomy Code	Specialty	Notes
207P00000X	Vascular Surgery	Common provider specialty performing iliac stenting and complex iliac revascularization.
207RC0000X	Interventional Cardiology	Performs peripheral endovascular interventions in some settings.
2080P0207X	Interventional Radiology	Frequently performs iliac arterial stent placement under imaging guidance.
207K00000X	General Surgery	Vascular-focused general surgeons may perform these procedures.
363L00000X	Physician Assistant	May assist or perform under supervision depending on state law and payer policy.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I70.213`	Atherosclerosis of native arteries of right leg with intermittent claudication	A common indication for iliac stenting to relieve claudication from iliac atherosclerotic disease.
`I70.212`	Atherosclerosis of native arteries of left leg with intermittent claudication	Same clinical relevance for left-sided iliac lesions leading to stent placement.
`I70.233`	Atherosclerosis of native arteries of right leg with ulceration	Complex peripheral disease with tissue loss may prompt revascularization including iliac stenting.
`I70.231`	Atherosclerosis of native arteries of right leg with rest pain	Rest pain from limb ischemia is an indication for urgent revascularization.
`I74.3`	Embolism and thrombosis of arteries of lower extremities	Acute embolic or thrombotic occlusion of an iliac vessel may require endovascular recanalization and stenting.
`I70.24`	Atherosclerosis of autologous vein bypass graft of the leg with intermittent claudication	Lesions in bypass graft inflow/outflow territories occasionally necessitate iliac intervention.
`K55.1`	Chronic mesenteric ischemia (included cautiously)	Rarely, complex aortoiliac disease affecting inflow to visceral circulation can intersect with iliac procedures.
`R65.21`	Severe sepsis with septic shock (not typical)	Included only when systemic conditions complicate revascularization decisions; uncommon direct indication.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`37220`	Revascularization, endovascular, open or percutaneous, femoral-popliteal, with transluminal angioplasty	May be performed in the same session for concomitant femoropopliteal disease; complementary peripheral angioplasty.
`37224`	Revascularization, endovascular, femoral-popliteal, with stent placement	Performed when stenting is required in femoropopliteal segment during the same treatment episode.
`75956`	Angiography, vascular, noncoronary, for transcatheter placement; initial vessel	Diagnostic angiography and guidance imaging that may be performed to define lesion anatomy prior to `37261`.
`36247`	Selective catheter placement, arterial catheterization, extremity (eg, iliac)	Can be performed as part of access and catheterization steps supporting `37261` (if reported separately by some payers).
`37262`	At the same session as an initial iliac revascularization service, additional stent in another ipsilateral or contralateral lesion (note: payers have distinct rules)	Closely related code used for additional or subsequent iliac stent placements in the same session depending on lesion count and payer policy.

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

CPT 37258: Iliac Artery Stent Placement for Straightforward Lesion

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

CPT 37260: Iliac Artery Stent Placement for Occlusive Lesion

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

Showing 1–10 of 32

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.

Published by

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

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CPT 37261: Stent Placement in Additional Iliac Vessel During Initial Revascularization

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Billing Code Overview

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CPT 37261: Stent Placement in Additional Iliac Vessel During Initial Revascularization

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References