Summary & Overview
CPT 61630: Intracranial Balloon Angioplasty
CPT code 61630 represents percutaneous transluminal balloon angioplasty of an intracranial artery. The procedure treats focal intracranial arterial stenosis by accessing the cerebral circulation via a percutaneous arterial approach—typically femoral—and inflating a balloon at the stenotic segment to restore vessel lumen. This endovascular neurointervention matters nationally because it is a specialized, resource-intensive procedure with implications for inpatient resource use, interventional radiology and neurosurgical capacity, and payer coverage policies for advanced neurovascular care.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context, typical sites of service, and common billing modifiers associated with this code. The publication summarizes reimbursement and utilization benchmarks, highlights notable policy or coverage considerations affecting payment and site-of-service decisions, and situates the procedure within current clinical practice for management of intracranial arterial stenosis. Data limitations: Data not available in the input for associated taxonomies, specific ICD-10 diagnosis pairings, and related codes.
Billing Code Overview
CPT code 61630 describes percutaneous transluminal balloon angioplasty of a stenotic intracranial artery. In this procedure, a provider inserts a catheter percutaneously—commonly via the femoral artery in the groin—then advances it through the bloodstream to the narrowed cerebral artery and inflates a small balloon at the site of plaque to dilate the vessel and reduce stenosis.
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Service type: Endovascular intracranial balloon angioplasty
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Typical site of service: Hospital-based catheterization laboratory or interventional neuroradiology suite; may also occur in specialized ambulatory surgical centers equipped for endovascular neurointerventions
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with symptomatic high-grade intracranial atherosclerotic stenosis of the internal carotid artery presents with recurrent transient ischemic attacks despite optimal medical therapy. The neurointerventional team evaluates the patient in the angiography suite. Under conscious sedation or general anesthesia, the provider obtains percutaneous arterial access (commonly the right common femoral artery), advances a guide catheter to the cervical carotid, and navigates a microcatheter and angioplasty balloon to the intracranial stenotic segment under fluoroscopic guidance. After angiographic confirmation of the lesion and roadmapping, the operator inflates a small compliant or noncompliant balloon to dilate the stenotic artery, restores luminal diameter, and assesses for residual stenosis and complications (dissection, perforation). Postprocedure, the patient is transferred to a monitored setting for neurovascular observation with neuro checks, blood pressure control, and antiplatelet management. Typical documentation includes indication, access site, vessels treated, balloon type and size, inflation pressures and durations, procedural complications, and immediate angiographic result.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default (no modifier) | Use when no special circumstances apply. |
| 11 | Primary procedure | Rarely used by facilities; may be applied by some payors to indicate the primary billed procedure. |