Summary & Overview
CPT 37279: Intravascular Lithotripsy During Femoral/Popliteal Revascularization
CPT code 37279 identifies intravascular lithotripsy (IVL) performed in one femoral or popliteal vessel during the same session as an initial femoral or popliteal revascularization. IVL is an endovascular adjunct that uses acoustic energy to fracture vascular calcium and facilitate vessel expansion and stent deployment. Nationally, use of IVL addresses the growing clinical challenge of heavily calcified peripheral arterial disease, with implications for procedure complexity, device utilization, and reimbursement pathways.
Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise synthesis of what CPT code 37279 represents clinically, the typical site of service, and the service category. The publication also outlines expected benchmarking areas and policy-relevant topics readers can pursue elsewhere: payer coverage patterns and prior authorization trends, coding and billing considerations when IVL is performed during initial revascularization, clinical context for device and procedural selection, and the relationship of this code to related endovascular codes. Data not available in the input will be noted where applicable.
Billing Code Overview
CPT code 37279 describes intravascular lithotripsy performed in one femoral or popliteal vessel during the same session as an initial femoral or popliteal revascularization service. The technique uses sound waves to fracture calcified plaque or arterial calcium to facilitate revascularization in the treated vessel territory. The described territory groups the common femoral and profunda femoris together, and the superficial femoral and popliteal together.
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Service type: Endovascular adjunct (intravascular lithotripsy) performed at the time of initial femoral or popliteal revascularization
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Typical site of service: Hospital outpatient department or ambulatory surgical center where endovascular peripheral vascular procedures are performed
Clinical & Coding Specifications
Clinical Context
A typical patient is an older adult with symptomatic peripheral artery disease (PAD) presenting with lifestyle-limiting claudication or ischemic rest pain and significant focal calcified stenosis within the femoral or popliteal arterial segments. The patient undergoes an initial femoral or popliteal endovascular revascularization (angioplasty and/or stent) during a single endovascular session. During the same session, the interventionalist performs intravascular lithotripsy (37279) to fracture and modify intimal and medial arterial calcium in the treated femoral or popliteal vessel to facilitate vessel dilation and optimize luminal gain. The procedure is performed under fluoroscopic imaging in an endovascular suite or catheterization laboratory with vascular surgery or interventional radiology teams available. Typical workflow: pre-procedure vascular assessment and consent; arterial access (commonly common femoral artery); diagnostic angiography to localize lesions; initial revascularization (angioplasty/stent) of the femoral or popliteal territory; intravascular lithotripsy (37279) applied to the calcified segment; adjunctive balloon angioplasty and/or stent placement as needed; completion angiography; hemostasis and post-procedure monitoring. Usual site of service is an outpatient endovascular suite, hospital outpatient department, or inpatient interventional radiology/catheterization laboratory depending on patient comorbidity and payer requirements.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 |