Summary & Overview
CPT 37270: Stent Placement for Complex Femoral or Popliteal Occlusion
CPT code 37270 describes placement of a stent (with angioplasty when performed) for a complex occlusive lesion in an additional femoral or popliteal vessel during the same session as an initial femoral or popliteal revascularization. The code matters nationally because peripheral arterial disease with femoral–popliteal occlusions is common, clinically significant, and associated with high-cost inpatient and outpatient vascular interventions. Proper coding supports accurate clinical documentation, payment, and tracking of complex endovascular and hybrid procedures.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical service captured by the code, typical sites of service, and the relationship of 37270 to initial revascularization procedures. The publication also summarizes common billing considerations and how payers generally view additional-vessel stent placement performed during the same session. Benchmarks and policy update summaries are provided where available. This national overview assists coding, billing, and clinical teams in identifying where 37270 fits in the procedure mix and in payer coverage discussions.
Data not available in the input for specific modifiers, associated taxonomies, ICD-10 diagnoses, related codes, and service-line categorizations.
Billing Code Overview
CPT code 37270 describes stent placement (with angioplasty when performed) for a complex occlusive lesion in an additional vessel within the femoral and popliteal vascular territory when performed at 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.
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Service type: Peripheral arterial stent placement for complex occlusive lesion performed during the same session as initial femoral or popliteal revascularization
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Typical site of service: Hospital outpatient department or inpatient operating room or interventional radiology/cardiac catheterization lab, performed via open or percutaneous approach
Clinical & Coding Specifications
Clinical Context
A 72-year-old male with a history of peripheral arterial disease presents with worsening right lower extremity claudication and an ankle-brachial index of 0.45. Diagnostic angiography in the vascular lab demonstrates an acute or chronic total occlusion of the superficial femoral artery in addition to an initial femoral revascularization site treated earlier in the same session. The interventional vascular surgeon proceeds with crossing the additional occluded vessel, performs angioplasty as needed, and deploys a stent in that complex lesion during the same operative session. The service includes arterial access, catheterization, lesion crossing maneuvers, intraprocedural imaging and guidance, and stent deployment. Typical workflow: pre-procedure review of imaging and comorbidities, informed consent, sterile arterial access (percutaneous or open), diagnostic angiography, lesion crossing and angioplasty, stent placement in the additional femoral/popliteal vessel, completion angiography, hemostasis and post-procedure monitoring in recovery or an inpatient setting as clinically indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure | Use when a distinct E/M service is medically necessary and documented on the same day as the revascularization and stent placement |