Summary & Overview

CPT 37284: Tibial/Peroneal Stent Placement with Angioplasty

CPT code 37284 denotes stent placement with angioplasty for a straightforward stenotic lesion in an initial tibial or peroneal artery (anterior tibial, posterior tibial, or peroneal). This endovascular peripheral arterial intervention is a key treatment option for limb ischemia and symptomatic peripheral arterial disease, and it matters nationally because it affects hospitalization patterns, vascular surgery and interventional radiology practice, and payer coverage decisions for lower-extremity revascularization.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find a concise overview of the service type and typical sites of service, plus national benchmarking context commonly used by payers and health systems. The publication summarizes coding scope for tibial and peroneal stent deployment, clarifies the clinical scenarios in which the code applies, and highlights where stakeholders look for alignment between clinical documentation and billing. Where available, benchmarking and policy updates relevant to coverage, medical necessity review, and site-of-service considerations are summarized.

This report is written for clinicians, billing professionals, and policy analysts seeking a focused reference on CPT code 37284, its clinical role in peripheral arterial interventions, and the payer landscape relevant to reimbursement and utilization oversight.

AetnaBlue Cross Blue ShieldCignaUnitedHealthcareMedicare37284CPTPeripheral arterial interventionEndovascularStent placementAngioplastyTibial arteriesPeroneal arteryVascular surgery

Billing Code Overview

CPT code 37284 describes stent placement with angioplasty, for a straightforward lesion in an initial tibial or peroneal artery. The procedure involves deployment of a small mesh stent to maintain arterial patency in the tibial and peroneal vascular territory, which includes the anterior tibial, posterior tibial, and peroneal arteries. The service includes all access, catheterization, lesion crossing, and imaging guidance necessary to complete the intervention.

Service type: Endovascular peripheral arterial intervention (stent placement with angioplasty) for tibial/peroneal vessels

Typical site of service: Hospital inpatient or outpatient interventional suite, or ambulatory surgical center (percutaneous or open approach)

Clinical & Coding Specifications

Clinical Context

A typical patient is a 68-year-old with progressive rest pain and non-healing ischemic ulceration of the foot secondary to peripheral artery disease (PAD) involving the tibial-peroneal runoff. The patient has diabetes mellitus, hypertension, and hyperlipidemia and has undergone duplex ultrasound and diagnostic lower-extremity angiography confirming a focal, straightforward stenotic lesion within an initial tibial or peroneal artery (anterior tibial, posterior tibial, or peroneal artery). After informed consent, the patient is brought to an angiography suite or hybrid operating room for endovascular intervention. Access is commonly via a common femoral artery puncture (percutaneous) but may be via an open surgical exposure if required. Under fluoroscopic guidance, the operator performs catheterization and lesion crossing with guidewires and catheters, performs angioplasty as needed, and deploys a single stent to scaffold the stenotic segment. Intra-procedural imaging and hemostasis are performed; post-procedure, the patient recovers in an ambulatory procedural recovery area or inpatient vascular unit depending on comorbidity and discharge criteria. Follow-up includes vascular lab testing and wound care as indicated.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	When billing only the physician component for imaging interpretation or professional services distinct from facility billing.
`TC`	Technical component	When billing only the facility/technical component for imaging or equipment use.
`59`	Distinct procedural service	When a separate, distinct endovascular procedure or service is performed on the same date that is not typically bundled with the primary stent placement.
`24`	Unrelated E/M service during a postoperative period	For an unrelated evaluation and management service during the global period after the stent procedure.
`25`	Significant, separately identifiable E/M service on same day	For a significant E/M service provided the same day as the procedure (e.g., urgent change in clinical plan) documented separately.
`78`	Return to OR for a related procedure during the postoperative period	When an unplanned reoperation related to the initial vascular procedure occurs during the global period.
`79`	Unrelated procedure or service by the same physician during the postoperative period	For an unrelated procedure performed by the same physician during the global period.
`50`	Bilateral procedure	If bilateral tibial/peroneal interventions are performed and payer requires bilateral reporting (rare for `37284` which is per-vessel); use per payer guidance.
`LT`	Left side	Anatomical modifier when the procedure is performed on the left leg.
`RT`	Right side	Anatomical modifier when the procedure is performed on the right leg.

Taxonomy Code	Specialty	Notes
`207K00000X`	Interventional Cardiologist	Cardiologists who perform peripheral endovascular interventions, including tibial stent placement.
`207RG0100X`	Vascular Surgeon	Surgeons who perform both open and endovascular peripheral arterial interventions.
`2080P0005X`	Interventional Radiologist	Radiologists specializing in image-guided vascular procedures and endovascular treatment.
`207RH0000X`	General Cardiovascular Disease	Cardiovascular specialists who may perform peripheral endovascular procedures in some practices.
`2086S0105X`	Physician Assistant	Advanced practice providers who assist in or perform aspects of endovascular procedure under supervision.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I70.219`	Atherosclerosis of native arteries of the extremities, unspecified extremity, with intermittent claudication	A common cause of tibial stenosis addressed by angioplasty and stent placement to improve perfusion.
`I70.239`	Atherosclerosis of native arteries of the extremities, unspecified extremity, with rest pain	Indicates critical limb ischemia where tibial/peroneal stenting may relieve ischemic rest pain.
`I70.241`	Atherosclerosis of native arteries of the extremities, right leg with ulceration	Peripheral arterial disease with ischemic ulceration frequently requires revascularization such as tibial stent placement.
`I70.242`	Atherosclerosis of native arteries of the extremities, left leg with ulceration	Same clinical relevance for the left leg; revascularization supports wound healing.
`E11.51`	Type 2 diabetes mellitus with peripheral angiopathy without gangrene	Diabetes-related peripheral vascular disease increases risk of tibial arterial lesions treated with stent placement.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36215`	Selective catheter placement, arterial system; each first order thoracic, abdominal, neck or extremity branch, within a vascular family	May be reported for selective catheterization of tibial/peroneal branch vessels during diagnostic angiography preceding stent placement when separately reportable.
`36216`	Selective catheter placement, arterial system; second order thoracic, abdominal, neck or extremity branch, within a vascular family	Used for more distal selective catheterization of tibial/peroneal branches during diagnostic or therapeutic workup.
`37225`	Transcatheter placement of an intravascular stent(s), peripheral artery, initial vessel	May be used for peripheral stent placement in other non-tibial peripheral arteries; distinguishes stent placement in different vascular beds.
`37226`	Transcatheter placement of an intravascular stent(s), peripheral artery, each additional vessel or branch	Reported when more than one vessel receives stent placement during the same session, as an add-on to initial stent code.
`75898`	Angiography, peripheral, radiological supervision and interpretation	Report of angiographic imaging interpretation used to document and guide the procedure when billed separately.
`36475`	Endovascular mechanical thrombectomy, peripheral artery, including all mechanical/aspiration techniques	May be performed before stent placement if thrombus removal is required in the tibial/peroneal vessel.