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    OpenPayerBilling CodesIntravascular Ultrasound Procedures on Arteries and VeinsCPT cpt-37264-femoral-popliteal-additional-vessel-angioplasty
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    CPT 37264: Angioplasty of Additional Femoral/Popliteal Vessel

    Medicare pays $2283 on average nationally for this procedure.

    CPT code 37264 describes angioplasty (balloon expansion) of a straightforward lesion in an additional vessel within the femoral and popliteal vascular territory performed at the same session as an initial femoral or popliteal revascularization; the service includes all access, catheterization, lesion crossing, and imaging guidance needed to complete the procedure, and the approach may be open or percutaneous. This is an endovascular revascularization procedure performed the same day as an index femoral/popliteal intervention (service type: additional-vessel angioplasty during the same session) and is typically provided in an outpatient catheterization lab, vascular interventional suite, or operating room depending on whether the approach is percutaneous or open (typical site of service: outpatient interventional suite or OR).

    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).

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    Clinical & Coding Specifications

    Clinical Context

    A 72-year-old male with smoking history, peripheral arterial disease, and lifestyle-limiting right calf claudication is referred to vascular surgery after noninvasive testing demonstrates a hemodynamically significant stenosis of the right superficial femoral artery (SFA). During the same session as an initial femoral revascularization (open or percutaneous) to treat the primary lesion in the SFA, the interventionalist identifies a second, straightforward focal stenosis in the profunda femoris artery within the femoral/popliteal vascular territory. The provider performs balloon angioplasty of that additional lesion during the same anesthetic encounter.

    Pre-procedure workflow includes vascular lab imaging, medication reconciliation (antiplatelet and anticoagulation assessment), informed consent specific to endovascular femoral/popliteal interventions, and planning of access site (common femoral artery access or open cutdown). Intra-procedure steps include arterial access, catheter and sheath placement, lesion crossing, selective angiography for lesion characterization, balloon dilation of the additional vessel, and completion angiography. Post-procedure workflow includes hemostasis management, monitoring for access complications, assessment of distal perfusion, discharge instructions regarding antiplatelet therapy and wound care, and scheduling follow-up vascular clinic and duplex surveillance.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    37246Transcatheter placement of intravascular stent(s), peripheral artery, open or percutaneous, including angioplasty when performed; initial vesselMay be performed if angioplasty alone is insufficient and a stent is required in the primary treated vessel.

    37267 | Transcatheter placement of an intravascular stent(s), peripheral artery, with atherectomy when performed; initial vessel | Performed when plaque debulking (atherectomy) is needed in conjunction with stent placement during the revascularization session.

    37225 | Revascularization, endovascular, open or percutaneous, femoral/popliteal, initial vessel; with transluminal angioplasty | Represents the initial femoral or popliteal revascularization service commonly reported with 37264 for the additional vessel in the same session.

    36011 | Introduction of needle or intracatheter, arterial, cutdown, not including imaging guidance | May be reported for arterial cutdown access techniques when performed separately from percutaneous access.

    76937 | Ultrasound guidance for vascular access (e.g., duplex ultrasound) | Used when real-time ultrasound guidance is used for arterial access prior to angioplasty or revascularization.

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…
    56Modifier ‑56 indicates the reporting provider furnished only the preoperative management for a surgical procedure and did not perform the intraoperative or postoperative care. It is used in…- Use Modifier -56 when a provider performs only the preoperative management in a split‑care situation (one physician manages preop care while a different physician performs the intraoperative…
    P4Modifier P4 indicates the patient is ASA Physical Status IV — a patient with severe systemic disease that is a constant threat to life. It is assigned by the anesthesia provider and must be supported…- When to apply: Use modifier P4 only on anesthesia CPT codes (00100–01999) to indicate ASA Physical Status IV — a patient with severe systemic disease that is a constant threat to life (examples:…
    P5Modifier P5 denotes a moribund patient who is not expected to survive without the operative procedure and is used only with anesthesia CPT codes 00100–01999. The anesthesia provider must append P5…- Use modifier P5 only when the anesthesia provider determines the patient is moribund and not expected to survive without the operation, and append it only to anesthesia CPT codes 00100–01999…
    58Modifier 58 (Staged or related procedure/service by the same physician during the postoperative period) indicates that a subsequent procedure performed by the same provider during the…- Use modifier 58 when the same physician/QHP performs a procedure during the postoperative/global period of an earlier procedure and the subsequent procedure is either planned or anticipated…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    208800000X
    207RG0300X
    2084P0800X
    208200000X
    172V00000X
    261QP1100X
    163WN0800X
    1223P0106X

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

    CPT 37257: Angioplasty of Additional Complex Iliac Lesion

    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-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.
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