Summary & Overview
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.
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
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 |