Summary & Overview
CPT 37273: Atherectomy for Femoral-Popliteal Occlusion
CPT code 37273 captures atherectomy of a complex occlusive lesion in the femoral-popliteal arterial territory, including the common femoral/profunda and superficial femoral/popliteal vessels. It encompasses all access, catheterization, lesion crossing, and imaging guidance and may include angioplasty. Nationally, this code reflects care for patients with critical limb ischemia and symptomatic peripheral arterial disease requiring revascularization and is relevant to hospital and ambulatory surgical settings where endovascular and hybrid vascular procedures are performed.
Key payers addressed in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find benchmarks for utilization and payment trends, summaries of payer coverage patterns and policy considerations, and clinical context clarifying when this complex revascularization procedure is reported. The publication also outlines common billing and documentation considerations tied to lesion complexity and combined services, and it identifies related surgical and endovascular procedure codes for coding workflows. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 37273 describes an atherectomy of an occluded (completely blocked) lesion in an initial vessel of the femoral and popliteal vascular territory. The territory includes the common femoral/profunda femoris and the superficial femoral/popliteal arteries. The service covers all access, catheterization, lesion crossing, and imaging guidance and may be performed with adjunctive angioplasty.
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Service type: Endovascular/percutaneous or open surgical atherectomy with possible angioplasty for complex femoral-popliteal occlusive disease
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Typical site of service: Hospital outpatient department or inpatient operating/procedure room; may also be performed in an interventional radiology or vascular surgery suite depending on setting and approach
Clinical & Coding Specifications
Clinical Context
A typical patient is a 68-year-old with progressive left lower-extremity claudication and rest pain due to peripheral arterial disease (PAD). Noninvasive testing (ankle-brachial index, arterial duplex, or CTA) demonstrates a chronic total occlusion of the superficial femoral artery extending into the popliteal segment. Medical management including antiplatelet therapy, statin, and supervised exercise has failed to control symptoms.
The vascular surgery or interventional radiology team schedules an endovascular intervention. In the hybrid suite or interventional lab, conscious sedation or general anesthesia is provided based on patient comorbidity. Vascular access is obtained (common femoral or alternative access), and diagnostic angiography is performed to confirm lesion morphology. The operator performs lesion crossing maneuvers, then atherectomy of the occluded femoral-popliteal segment using an approved device; adjunctive angioplasty and stent placement may follow if residual stenosis or significant recoil exists. Intravascular imaging (IVUS) or fluoroscopic guidance is used throughout. Hemostasis is achieved by manual compression or percutaneous closure device. Post-procedure monitoring occurs in a recovery area with assessment of distal pulses and access site.
Typical sites of service include the hospital-based operating room (open approach) or hospital outpatient department/interventional radiology suite and ambulatory surgical center for percutaneous procedures. The service includes all access, catheterization, lesion crossing, and imaging guidance for the initial treated vessel in the femoral-popliteal territory.
Coding Specifications
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