Summary & Overview
CPT 37292: Tibial/Peroneal Revascularization with Stent and Atherectomy
CPT code 37292 defines revascularization of an initial tibial or peroneal vessel that combines stent placement and atherectomy, and may include angioplasty as part of a single, straightforward lesion intervention. This code captures comprehensive procedural work — access, catheterization, lesion crossing, and imaging guidance — and applies to the anterior tibial, posterior tibial, and peroneal arteries. It is relevant nationally as limb-salvage and peripheral arterial disease management increasingly rely on complex endovascular techniques.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical intent and service setting, followed by benchmarking context for reimbursement and utilization trends where available. The publication summarizes common billing considerations, typical sites of service (hospital outpatient departments, ambulatory surgery centers, and procedural suites), and the clinical scenarios in which CPT code 37292 is applied. The material is organized to support coding accuracy, payer contract review, and operational planning for vascular programs. Data not available in the input is noted where applicable, and the content focuses on nationally applicable policy and clinical context without state-specific guidance.
Billing Code Overview
CPT code 37292 describes endovascular revascularization of a single tibial or peroneal artery that includes both stent placement and atherectomy (plaque removal), and may include angioplasty. The procedure covers all components necessary to complete the intervention, including vascular access, catheterization, lesion crossing, and imaging guidance. The covered vascular territory is the tibial and peroneal arteries: the anterior tibial, posterior tibial, and peroneal arteries.
Service type: Peripheral endovascular revascularization with combined stent and atherectomy for a straightforward tibial/peroneal lesion
Typical site of service: Hospital outpatient department or ambulatory surgery center for percutaneous approaches; operating room or procedural suite for open or hybrid approaches.
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with peripheral arterial disease presents with progressive ischemic rest pain and non-healing ulceration of the foot. Noninvasive testing (ABI and duplex ultrasound) shows severe tibial vessel stenosis. After multidisciplinary evaluation, the vascular interventional team proceeds with endovascular revascularization of an initial tibial/peroneal vessel. The provider obtains arterial access (commonly common femoral or antegrade tibial access), performs diagnostic catheter angiography to localize the lesion, uses an atherectomy device to debulk plaque, places an intravascular stent in the treated segment, and may perform adjunctive angioplasty. Intra-procedural imaging guidance and catheter-based techniques are used for lesion crossing and stent deployment. The patient is monitored in a vascular recovery area post-procedure and discharged with antiplatelet therapy and wound care follow-up as appropriate.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when only the physician interpretation component is billed separately from facility services. |
50 | Bilateral procedure | Use if the same procedure is performed on both legs during the same operative session and payer allows bilateral reporting.
59 | Distinct procedural service | Use when another distinct procedure unrelated to the revascularization is performed and not normally bundled.