Summary & Overview
CPT 37281: Angioplasty of Additional Tibial/Peroneal Vessel
CPT code 37281 represents angioplasty of an additional straightforward lesion in the tibial or peroneal arterial territory performed during the same session as an initial tibial or peroneal revascularization. This adjunct endovascular procedure targets stenoses in the anterior tibial, posterior tibial, or peroneal arteries and includes all access, catheterization, lesion crossing, and imaging guidance necessary to complete treatment. Nationally, this code is used in the management of peripheral arterial disease (PAD) affecting below-knee runoff vessels and can affect care coordination, facility utilization, and payer coverage determinations for limb-salvage interventions.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context and expected service settings, along with benchmarks and policy-relevant considerations typically included in payer analyses. The publication outlines typical use cases for 37281, highlights how it integrates with tibial/peroneal revascularization services, and summarizes the operational aspects that influence billing and facility workflows. Data not available in the input for specific modifiers, associated taxonomies, ICD-10 pairings, and related codes are noted where applicable.
Billing Code Overview
CPT code 37281 describes angioplasty (balloon expansion) of a straightforward stenotic lesion in an additional vessel within the tibial and peroneal vascular territory performed at the same session as an initial tibial or peroneal revascularization. The specified vascular territory includes the anterior tibial, posterior tibial, and peroneal arteries. The service encompasses all necessary access, catheterization, lesion crossing, and imaging guidance required to complete the procedure.
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Service type: Endovascular peripheral angioplasty adjunct to tibial/peroneal revascularization
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Typical site of service: Hospital-based or ambulatory endovascular suite, including inpatient or outpatient vascular/interventional radiology settings
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with peripheral arterial disease presents with rest pain and a non-healing ulcer of the forefoot. Noninvasive testing (ABI, arterial Doppler) and angiography demonstrate significant stenosis of a tibial artery and an additional straightforward focal stenosis in a second tibial/peroneal vessel. During the same endovascular session as the initial tibial or peroneal revascularization, the interventional vascular specialist performs balloon angioplasty of the additional straightforward lesion in the tibial/peroneal territory. The procedure includes arterial access, catheterization, lesion crossing, balloon dilation, and intraprocedural imaging. Typical workflow: pre-procedure evaluation and consent in the angiography suite, local anesthesia ± conscious sedation, arterial access (commonly contralateral femoral or ipsilateral retrograde tibial), diagnostic angiography to define lesions, crossing of the primary lesion with guidewires, angioplasty of the primary tibial/peroneal vessel, then angioplasty of the additional straightforward tibial/peroneal lesion (coded as 37281), post-dilation angiography, hemostasis/closure, and post-procedure monitoring with vascular checks and discharge instructions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable E/M service by the same physician on the same day of procedure | Use when a distinct evaluation/management visit is performed on the same day as the angioplasty prior to the procedure |