CPT 37283 Reimbursement & Benchmarks | OpenPayer

Summary & Overview

CPT 37283: Angioplasty of Complex Tibial/Peroneal Lesion

CPT code 37283 represents an endovascular angioplasty of a complex lesion (including complete occlusion) in an additional tibial or peroneal artery performed during the same session as an initial tibial or peroneal revascularization. The code is used to capture the angioplasty service in the anterior tibial, posterior tibial, or peroneal arteries and includes all access, catheterization, lesion crossing, and imaging guidance necessary to complete the procedure. Nationally, this code matters because peripheral arterial disease interventions are common and increasingly performed in ambulatory settings, making accurate coding essential for clinical documentation and payer adjudication. Key payers examined include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context of the procedure, guidance on typical sites of service, and an overview of reimbursement and coverage considerations reflected across major national payers. The publication also highlights benchmarks and coding relationships relevant to vascular surgery, interventional radiology, and hospital outpatient billing workflows. Data not available in the input regarding specific modifiers, taxonomies, ICD-10 pairings, and related codes is noted elsewhere in the full publication.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 37283tibial angioplastyperoneal angioplastyperipheral arterial diseaseendovascular procedureangioplasty complex lesionvascular interventionoutpatient surgery

Billing Code Overview

CPT code 37283 describes an angioplasty procedure performed in the tibial and peroneal arterial territory at the same session as an initial tibial or peroneal revascularization. The service covers balloon expansion of a complex lesion, such as a complete occlusion, in an additional vessel within the anterior tibial, posterior tibial, or peroneal arteries. The procedure includes all access, catheterization, lesion crossing, and imaging guidance required to complete the angioplasty.

Service type: Endovascular angioplasty for complex tibial/peroneal lesions performed during the same session as an initial tibial or peroneal revascularization
Typical site of service: Hospital outpatient department or ambulatory surgery center where peripheral vascular interventions are performed

Clinical & Coding Specifications

Clinical Context

A 68-year-old patient with diabetes mellitus and peripheral arterial disease presents with a nonhealing plantar ulcer and rest pain in the foot. Noninvasive arterial testing and diagnostic angiography demonstrate an occluded tibial artery supplying the plantar circulation with additional significant stenosis or an occlusion in a second tibial or peroneal vessel. During the same endovascular session when the primary tibial or peroneal revascularization is performed, the interventionalist performs an additional balloon angioplasty of a complex lesion (complete occlusion or chronic total occlusion) in another tibial/peroneal vessel to improve distal perfusion.

The clinical workflow includes: pre-procedure assessment and informed consent; percutaneous arterial access (commonly femoral or antegrade tibial access); diagnostic angiography to map tibial and peroneal anatomy; crossing of the complex lesion using guidewires and support catheters; balloon angioplasty of the target additional tibial/peroneal vessel; intraprocedural imaging to document technical success; hemostasis and post-procedure monitoring with vascular assessment and wound care planning. Documentation should note that the additional angioplasty was performed at the same session as the initial tibial/peroneal revascularization, describe lesion complexity (occlusion), access, devices used, and immediate angiographic result.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component

CPT 37258: Iliac Artery Stent Placement for Straightforward Lesion

CPT-37264-FEMORAL-POPLITEAL-ADDITIONAL-VESSEL-ANGIOPLASTY

CPT 37264: Additional-Vessel Femoral/Popliteal Angioplasty

CPT-37272-FEMORAL-POPLITEAL-ATHERECTOMY-ADDITIONAL-VESSEL

CPT 37272: Atherectomy of Additional Femoral/Popliteal Lesion

CPT-37299-INFRAMALLEOLAR-ANGIOPLASTY-ADDITIONAL-COMPLEX-LESION

CPT 37299: Inframalleolar Angioplasty for Complex Lesion

CPT-37290-TIBIAL-PERONEAL-ATHERECTOMY-OCCLUSION

CPT 37290: Atherectomy for Tibial/Peroneal Occlusion

CPT-37286-TIBIAL-PERONEAL-ARTERY-STENT-PLACEMENT-OCCLUSION

CPT 37286: Stent Placement for Tibial/Peroneal Artery Occlusion

CPT-37276-ATHERECTOMY-STENT-FEMORAL-POPLITEAL-ADDITIONAL-VESSEL

CPT 37276: Atherectomy and Stent Placement in Additional Femoral/Popliteal Vessel

CPT-37284-TIBIAL-PERONEAL-STENT-PLACEMENT-ANGIOPLASTY

CPT 37284: Tibial/Peroneal Stent Placement with Angioplasty

CPT-37271-PERIPHERAL-ATHERECTOMY-FEMORAL-POPLITEAL

CPT 37271: Peripheral Atherectomy, Femoral/Popliteal Territory

CPT-37267-FEMORAL-POPLITEAL-STENT-PLACEMENT

CPT 37267: Femoral and Popliteal Arterial Stent Placement

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Taxonomy Code	Specialty	Notes
`208D00000X`	Vascular Surgery	Commonly performs tibial/peroneal endovascular revascularization.
`207T00000X`	Interventional Cardiology	Performs peripheral endovascular interventions in some centers.
`2084P0800X`	Interventional Radiology	Frequently performs tibial/peroneal angioplasty and occlusion crossing.
`207K00000X`	Family Medicine with Procedural Focus	Less common; may assist in limb salvage programs.
`207L00000X`	Internal Medicine	May be primary care referring or hospitalist coordinating care.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I70.213`	Atherosclerosis of native arteries of the right leg with rest pain	Peripheral arterial disease causing limb ischemia often treated with tibial/peroneal angioplasty.
`I70.214`	Atherosclerosis of native arteries of the left leg with rest pain	As above, left-sided presentation prompting revascularization.
`I70.23`	Atherosclerosis of native arteries of extremities with ulceration	Ulceration indicates critical limb ischemia where tibial/peroneal angioplasty may be required for limb salvage.
`I70.24`	Atherosclerosis of native arteries of extremities with gangrene	Gangrene reflects severe ischemia; endovascular revascularization can be part of limb salvage efforts.
`I96`	Gangrene, not elsewhere classified	Clinical end-stage ischemia manifestation that may prompt revascularization procedures.
`E11.51`	Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene	Diabetes is a major risk factor for tibial/peroneal occlusive disease leading to angioplasty procedures.
`R02`	Gangrene, not specified as to limb	Indicates ischemic tissue loss that may be addressed by revascularization.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`37282`	Endovascular revascularization, tibial/peroneal, open or percutaneous, initial vessel (eg, balloon angioplasty, atherectomy), including all associated radiological supervision and interpretation and imaging guidance when performed	Represents the initial tibial or peroneal revascularization service performed in the same session; `37283` is used for an additional complex lesion in another tibial/peroneal vessel performed at the same session.
`36247`	Selective catheter placement, extremity artery, within the leg or foot, with radiological supervision and interpretation	May be reported for selective catheterization when required for diagnostic mapping or when not bundled by payer with therapeutic codes.
`37284`	Endovascular revascularization, tibial/peroneal, each additional vessel, percutaneous, not within the same session as initial tibial/peroneal service	Used when additional vessel interventions occur in a separate session; contrasts with `37283` which is additional vessel at the same session for complex lesion.
`36147`	Introduction of needle or catheter into peripheral artery for diagnostic angiography, with radiological supervision and interpretation	Represents arterial access and diagnostic angiography components that precede therapeutic angioplasty when coded separately.
`76937`	Ultrasound guidance for vascular access (e.g., non-central venous)	May be used when ultrasound was employed for arterial access during the procedure.

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