Summary & Overview
CPT 37286: Stent Placement for Tibial/Peroneal Artery Occlusion
CPT code 37286 describes stent placement, with angioplasty when performed, for complex occlusive lesions in an initial tibial or peroneal artery (anterior tibial, posterior tibial, or peroneal). The code bundles all access, catheterization, lesion crossing, and imaging guidance required to treat a complete blockage or severe occlusion in the tibial/peroneal vascular territory. This service is relevant to limb-salvage and peripheral arterial disease management and is commonly performed in hospital-based interventional suites and ambulatory surgical centers. Nationwide, the utilization and coverage of CPT code 37286 affect vascular specialists, hospitals, and payers as they balance clinical need, device use, and episodic costs associated with complex endovascular procedures.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of clinical context for tibial/peroneal stenting, coverage considerations across major payers, common billing and service-line implications, and related procedural codes to consider when coding peripheral vascular interventions. The publication highlights benchmarks and policy-relevant issues affecting reimbursement and access for endovascular limb-salvage procedures, and provides practical clarity on when CPT code 37286 applies versus other peripheral vascular codes.
Billing Code Overview
CPT code 37286 describes stent placement with or without adjunctive angioplasty for a complex occlusive lesion in an initial tibial or peroneal vessel. The procedure targets the anterior tibial, posterior tibial, or peroneal arteries and is intended to restore or maintain blood flow in a severely narrowed or fully occluded tibial/peroneal artery.
The service includes all necessary access, catheterization, lesion crossing, and imaging guidance required to complete the intervention. The approach may be percutaneous or open, and angioplasty performed at the time of stent deployment is included in the code.
Service type: Endovascular or vascular interventional procedure (stent deployment with possible angioplasty)
Typical site of service: Hospital inpatient or outpatient interventional suites (including catheterization labs) and ambulatory surgical centers, depending on patient condition and facility capabilities.
Clinical & Coding Specifications
Clinical Context
A typical patient is an older adult with peripheral arterial disease presenting with lifestyle-limiting claudication or critical limb ischemia (rest pain, non-healing foot ulcer, or gangrene) localized to the lower leg and foot. After duplex ultrasound and diagnostic angiography identify a complex tibial or peroneal lesion (chronic total occlusion or long-segment stenosis) in an initial tibial/peroneal vessel (anterior tibial, posterior tibial, or peroneal artery), the vascular specialist (interventional cardiologist, vascular surgeon, or interventional radiologist) schedules an endovascular revascularization procedure.
The clinical workflow includes pre-procedure risk assessment, informed consent, and review of imaging. In the angiography suite or hybrid operating room the team obtains arterial access (percutaneous common femoral or antegrade tibial access as indicated), advances catheters under fluoroscopic guidance, crosses the lesion with wire and catheter techniques, performs balloon angioplasty as needed, and deploys a self-expanding or balloon-expandable stent in the targeted tibial or peroneal artery to treat the complex occlusion. Intra-procedural imaging (angiography) documents technical success. The service 37286 includes all access, catheterization, lesion crossing, imaging guidance, and angioplasty when performed for the initial treated tibial/peroneal vessel. Post-procedure monitoring includes hemostasis, vascular checks, and discharge planning with antiplatelet therapy and wound care or follow-up surveillance imaging as clinically indicated.
Coding Specifications
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