Summary & Overview

CPT 37268: Additional Femoral/Popliteal Vessel Stent Placement During Same Session

CPT code 37268 captures placement of a stent (with angioplasty when performed) for a straightforward stenotic lesion in an additional femoral or popliteal vessel performed in the same session as an initial femoral or popliteal revascularization. The code bundles all access, catheterization, lesion crossing, and imaging guidance and applies to open or percutaneous approaches. Nationally, accurate use of this code matters for proper procedural reporting, claims consistency, and payment for complex peripheral vascular interventions.

Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical intent and service setting, standard billing considerations, common payer coverage patterns, and comparable procedure relationships. The publication outlines benchmarks for utilization and allowed amounts where available, summarizes relevant policy language and prior authorization trends, and highlights coding relationships with primary femoral/popliteal revascularization services.

This resource is intended for revenue cycle leaders, vascular specialists, interventional radiology teams, and compliance officers seeking a national perspective on coding and payer handling of additional-vessel stent placement in the femoral/popliteal territory. Data not available in the input will be noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare37268CPTperipheral-vascularstent-placementfemoral-poplitealendovascularinterventional-radiologyvascular-surgery

Billing Code Overview

CPT code 37268 describes placement of a stent (with angioplasty when performed) in an additional straightforward lesion (stenosis) in the femoral and popliteal vascular territory during the same session as an initial femoral or popliteal revascularization service. The territory includes the common femoral/profunda femoris and the superficial femoral/popliteal arteries. The service includes all access, catheterization, lesion crossing, and imaging guidance. The approach may be open or percutaneous.

Service type: Peripheral vascular stent placement as an add-on during the same session as an initial femoral or popliteal revascularization

Typical site of service: Hospital operating room, endovascular suite, or interventional radiology/cardiac catheterization laboratory (inpatient or outpatient settings as clinically indicated)

Clinical & Coding Specifications

Clinical Context

A 72-year-old patient with lifestyle-limiting claudication and an angiographically confirmed focal stenosis of the superficial femoral artery undergoes an initial femoral-popliteal revascularization during the same session. After successful angioplasty and stent placement in the primary target vessel, the operator identifies a second, straightforward focal stenosis in an adjacent femoropopliteal vessel (for example, a lesion in the distal superficial femoral artery or proximal popliteal artery). The provider performs percutaneous catheter-based access, diagnostic and therapeutic catheterization, lesion crossing, adjunctive angioplasty as needed, and deployment of a stent in the additional vessel during the same operative session. Imaging guidance (fluoroscopy/angiography) is used throughout, and hemostasis and access-site management are completed before recovery. Typical workflow includes preprocedure assessment and consent, vascular access (usually contralateral or ipsilateral common femoral artery), diagnostic angiography, primary revascularization procedure, identification of the additional straightforward lesion, treatment with angioplasty and stent placement (37268), final angiographic confirmation of vessel patency, and postprocedure monitoring in a vascular recovery area or inpatient setting depending on comorbidity and payor coverage.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component

Taxonomy Code	Specialty	Notes
207K00000X	Vascular Surgery	Vascular surgeons routinely perform femoral/popliteal revascularization and stent placement.
207RH0000X	Interventional Cardiology	Interventional cardiologists with peripheral intervention training perform lower extremity endovascular procedures.
207X00000X	Interventional Radiology	Interventional radiologists commonly perform percutaneous angioplasty and stenting with imaging guidance.
2086S0122X	General Surgery with Vascular	General surgeons with vascular privileges may perform open or hybrid femoral-popliteal procedures.
363A00000X	Physician Assistant	Physician assistants may assist or perform parts of the procedure under supervising physician protocols.

ICD-10 Code	Description	Clinical Relevance
`I70.219`	Atherosclerosis of native arteries of the extremities, unspecified, bilateral	Peripheral atherosclerotic disease causing femoropopliteal stenosis amenable to stent placement.
`I70.213`	Atherosclerosis of native arteries of the extremities with intermittent claudication, right leg	Symptom commonly driving femoral/popliteal revascularization and stenting on the right side.
`I70.212`	Atherosclerosis of native arteries of the extremities with intermittent claudication, left leg	Symptom commonly driving femoral/popliteal revascularization and stenting on the left side.
`I70.201`	Atherosclerosis of native arteries of the extremities, unspecified, right leg	Used when laterality or symptom specification is limited but disease is present.
`I70.209`	Atherosclerosis of native arteries of the extremities, unspecified, unspecified extremity	General code for peripheral arterial disease when laterality is not specified.
`I74.3`	Embolism and thrombosis of arteries of the lower extremities	Acute embolic or thrombotic events may precipitate urgent revascularization and adjunctive stenting after thrombectomy or thrombolysis.
`I96`	Gangrene, not elsewhere classified	Advanced ischemia with tissue loss may require revascularization including stenting to salvage limb.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`37246`	Revascularization, endovascular, open or percutaneous, iliac artery, stent placement(s), includes angioplasty when performed; initial vessel	Often performed earlier in the same session when proximal iliac disease requires treatment prior to femoropopliteal work; addresses inflow lesions.
`37250`	Transcatheter placement of intravascular stent(s), visceral/renal artery, with angioplasty when performed; initial vessel	Not typically in the femoropopliteal territory but listed here as an example of another stent placement family; used for non-lower-extremity peripheral stenting when relevant in broader peripheral interventions.
`37224`	Revascularization, endovascular, femoral or popliteal, thrombolysis, infusion and/or mechanical thrombectomy	May be performed before stent placement if there is thrombus burden requiring lysis or thrombectomy to restore flow prior to definitive stenting.
`37235`	Revascularization, endovascular, femoral/popliteal, percutaneous transluminal angioplasty; initial vessel	Commonly performed as the initial therapy for the primary lesion; `37268` is used when a stent is placed in an additional vessel during the same session.
`36147`	Introduction of needle(s) and/or catheter(s) for diagnostic angiography, lower extremity, percutaneous, includes radiological supervision and interpretation	Diagnostic catheterization and angiography are integral to case planning and are typically performed immediately before therapeutic interventions.
`36415`	Collection of venous blood by venipuncture	Performed as part of pre- and post-procedure laboratory assessment in the same encounter.

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