Summary & Overview
CPT 37269: Stent Placement for Complex Femoral-Popliteal Occlusion
CPT code 37269 represents stent placement (with angioplasty when performed) for a complex occlusive lesion — a complete blockage — in an initial vessel of the femoral and popliteal vascular territory. This code covers comprehensive procedural work including vascular access, catheterization, lesion crossing, stent deployment, and imaging guidance; the approach may be open or percutaneous. Nationally, the code is significant because peripheral arterial disease interventions in the femoral-popliteal segment are common drivers of hospital outpatient and ambulatory surgical center vascular procedural volumes and associated resource utilization.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and service settings, payer coverage considerations, and linked operational topics such as site-of-service implications and procedure complexity. The publication provides benchmarks and policy-relevant updates where available, clarifies the procedural scope of the code, and outlines related billing and clinical themes to inform revenue cycle, clinical, and policy stakeholders. Data not available in the input will be noted where specific payer policies, modifiers, taxonomies, ICD-10 pairings, or related codes are required.
Billing Code Overview
CPT code 37269 describes stent placement for a complex occlusive lesion in an initial vessel within the femoral and popliteal vascular territory. The service covers stent placement with angioplasty when performed for complete blockage (occlusion) of vessels in the common femoral/profunda femoris and the superficial femoral/popliteal arteries.
Service type: Endovascular peripheral arterial intervention (stent placement with possible angioplasty) performed for complex femoral/popliteal occlusive disease.
Typical site of service: Hospital outpatient department or ambulatory surgical center; the approach may be open or percutaneous, and the procedure includes all access, catheterization, lesion crossing, and imaging guidance.
Clinical & Coding Specifications
Clinical Context
A 72-year-old male with a history of peripheral artery disease, hypertension, hyperlipidemia, and tobacco use presents with progressively worsening right lower-extremity claudication and diminished ankle-brachial index. Noninvasive testing (duplex ultrasound and/or CTA) demonstrates an occlusive, complex lesion of the superficial femoral artery extending into the popliteal segment with near-complete luminal occlusion. The vascular surgery or interventional radiology team schedules an endovascular intervention.
The patient is admitted to an outpatient endovascular suite or hospital operating room under monitored anesthesia care or general anesthesia. Vascular access is obtained (commonly common femoral artery), diagnostic catheterization and imaging (angiography) are performed to delineate lesion anatomy, and lesion crossing techniques (wire and catheter manipulation, possible subintimal angioplasty) are used. Angioplasty may be performed followed by placement of one or more stents to restore durable inline flow in the femoral–popliteal arterial segment. The service includes all access, catheterization, lesion crossing, stent deployment, and fluoroscopic imaging guidance. Postprocedure, the patient is monitored for access site complications and limb perfusion, with discharge planned same day or after an overnight stay depending on comorbidities and procedural complexity.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component |