Summary & Overview
HCPCS C7531: Femoral-Popliteal Revascularization with Angioplasty and IVUS
HCPCS Level II code C7531 captures unilateral femoral or popliteal artery revascularization using endovascular, open, or percutaneous techniques that include transluminal angioplasty with intravascular ultrasound (IVUS) during diagnostic evaluation or therapeutic intervention, with radiological supervision and interpretation. This code is relevant nationally for vascular surgery, interventional radiology, and hospital revenue cycle teams because it designates a complex peripheral arterial revascularization procedure incorporating advanced imaging guidance.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of clinical context for peripheral arterial disease interventions, typical settings of care, common billing modifiers, and where available, payer coverage patterns and coding considerations. The publication highlights benchmarks and operational implications for hospital and outpatient endovascular programs, and summarizes the clinical scenarios in which IVUS-guided transluminal angioplasty of the femoral-popliteal segment is coded.
What readers will learn: how C7531 is defined and when it applies, which service lines and sites of service are typical, the list of commonly used modifiers, and which major payers are typically involved in reimbursement decisions. Data not available in the input will be noted where applicable.
Billing Code Overview
HCPCS Level II code C7531 describes revascularization of a unilateral femoral or popliteal artery using endovascular, open, or percutaneous approaches. The procedure includes transluminal angioplasty with intravascular ultrasound performed on an initial noncoronary vessel during diagnostic evaluation and/or therapeutic intervention, and includes radiological supervision and interpretation.
Service type: Revascularization procedure with transluminal angioplasty and intravascular ultrasound
Typical site of service: Hospital-based vascular interventional suite, inpatient operating room, or outpatient endovascular lab
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with a history of peripheral arterial disease, smoking, and poorly controlled diabetes presents with progressive left calf claudication and diminished pedal pulses. Noninvasive vascular testing (ankle-brachial index and duplex ultrasound) demonstrates a hemodynamically significant lesion of the left superficial femoral and popliteal artery. After diagnostic angiography confirms focal stenosis and intraluminal plaque burden, the vascular surgery/interventional radiology team performs an endovascular revascularization of the femoral-popliteal segment. The procedure includes transluminal percutaneous transluminal angioplasty (PTA) of the affected vessel with intravascular ultrasound (IVUS) used during the diagnostic evaluation and to guide balloon sizing and confirm stent apposition when applicable. Radiological supervision and interpretation are provided for the imaging portions, and the service is billed as a unilateral femoral–popliteal endovascular revascularization with transluminal angioplasty and IVUS during diagnostic evaluation/therapeutic intervention (C7531). Typical workflow includes preprocedure evaluation and consent, vascular access (commonly common femoral arterial access), diagnostic angiography, IVUS imaging, angioplasty (+/- adjunctive stent placement if indicated), hemostasis and postprocedure monitoring in an ambulatory surgery center or hospital vascular/interventional suite.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 |