Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.31
    OpenPayerBilling CodesOutpatient PPSHCPCS hcpcs-c7563-transluminal-balloon-angioplasty-non-excluded-arteries
    Ask Trek AI about this page

    HCPCS Level II C7563: Transluminal Balloon Angioplasty, Initial Artery

    HCPCS Level II code C7563 describes transluminal balloon angioplasty, open or percutaneous, for non-lower-extremity arteries (excluding intracranial, coronary, pulmonary, or dialysis circuit) and includes all imaging and radiological supervision and interpretation necessary to perform angioplasty within the same artery for the initial artery and any additional arteries; service type: vascular interventional procedure (angioplasty) performed via percutaneous or open approach; typical site of service: hospital interventional radiology suite, cardiac catheterization lab, or other procedural operating rooms where endovascular interventions are performed.

    For related coverage guidance, see recent payer policy updates: Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillation, Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillation, Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillation.

    Customize your policy alerts

    Sign up for hcpcs C7563 policy alerts

    Get alerted when payer policies referencing C7563 are released or updated.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Table of contents

    Progress1 / 7

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • Facility ComparisonBeds, revenue & payer mix
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Clinical & Coding Specifications

    Clinical Context

    A 68-year-old male with progressive intermittent claudication and lifestyle-limiting exertional leg pain is evaluated in the vascular surgery clinic. Noninvasive vascular testing (ankle-brachial index and duplex ultrasound) demonstrates focal atherosclerotic stenosis in a femoropopliteal artery. The patient has failed optimal medical therapy and supervised exercise and is scheduled for transluminal balloon angioplasty to restore luminal diameter.

    On the day of service the patient presents to an outpatient vascular suite or hospital-based interventional radiology/vascular surgery lab. Pre-procedure informed consent, pre-procedure antibiotics if indicated, vascular access planning (typically common femoral artery), and image guidance review are completed. Under conscious sedation or monitored anesthesia care, arterial access is obtained, diagnostic angiography is performed to localize the lesion, and balloon angioplasty of the target superficial femoral or popliteal artery is performed. All intra-procedural imaging and radiological supervision and interpretation required to perform the angioplasty within the same artery are provided. Post-procedure hemostasis, monitoring in PACU or observation unit, and discharge instructions or inpatient admission as clinically indicated complete the workflow.

    Typical site of service: outpatient hospital-based interventional radiology or vascular surgery suite, ambulatory surgical center, or inpatient operating room depending on comorbidity and anesthesia needs.

    Service type: endovascular transluminal balloon angioplasty (open or percutaneous) of non-coronary, non-intracranial, non-pulmonary, non-dialysis circuit peripheral arteries (excluding lower extremity occlusive disease procedures that have distinct codes).

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    36010Introduction of needle or intracatheter, central vein; diagnostic, not used for arterial access but commonly billed for central venous access when required for monitoring or medications during the procedure.May be performed contemporaneously if central venous access is obtained for medication or monitoring during complex cases.
    36200Angiography, diagnostic, peripheral, noncoronary, arterial, radiological supervision and interpretationPerformed immediately before angioplasty to define arterial anatomy and lesion location; provides baseline imaging.
    35476Endovascular revascularization, open or percutaneous, femoral/popliteal, transluminal balloon angioplastyCommonly paired or used synonymously for lower extremity angioplasty procedures; used depending on exact anatomic descriptor and payer rules.
    37220Revascularization, endovascular, open or percutaneous, with transluminal angioplasty, peripheral artery(ies), initial vesselRepresents peripheral arterial angioplasty and may be used for coding when procedure maps to CPT guidelines.
    76937Ultrasound guidance for vascular accessUsed when ultrasound guidance is used for arterial access prior to angioplasty.

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    51Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207W00000X
    207X00000X
    2085R0202X
    163WI0600X
    207PE0005X
    302R00000X
    103TC0700X
    246QI0000X

    Related ICD-10-CM Codes

    25 rows

    ICD-10-CM CodeDescription
    I65.21Occlusion and stenosis of right carotid artery
    I65.22Occlusion and stenosis of left carotid artery
    I65.23Occlusion and stenosis of bilateral carotid arteries
    I66.01Occlusion and stenosis of right middle cerebral artery
    I66.02Occlusion and stenosis of left middle cerebral artery
    I66.03Occlusion and stenosis of bilateral middle cerebral arteries
    I70.209Unspecified atherosclerosis of native arteries of extremities, unspecified extremity
    I70.219Atherosclerosis of native arteries of extremities with intermittent claudication, unspecified extremity
    I70.229Atherosclerosis of native arteries of extremities with rest pain, unspecified extremity
    I70.231Atherosclerosis of native arteries of right leg with ulceration of thigh

    Showing 1–10 of 25

    Related Payer Policy Updates

    Specialty: Cardiology1 / 3

    10 rows

    PolicyPayerEffective Date
    Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillationpremerabluecrossofwashington2027-02-05
    Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillationpremerabluecrossofwashington2027-02-05
    Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillationpremerabluecrossofwashington2027-02-05
    Percutaneous Left Atrial Appendage Closure - Medical PolicyHealth-New-England2027-02-01
    Transcatheter Mitral Valve Repair Medical PolicyHealth-New-England2027-02-01
    Cardiac Electrophysiological (EP) Studies and Cardiac Ablation of Abnormal Electrical RhythmsCigna2027-01-15
    IvabradineCigna2026-11-15
    Tilt Table TestingCigna2026-11-15
    Outpatient Cardiology Procedures for EviCore Arrangement (for Oxford Only)Colorado Rocky Mountain Health Plans2026-11-01
    Biomarkers for Myocardial Infarction and Chronic Heart Failure Reimbursement PolicyHealthfirst2026-11-01

    Related Codes

    HCPCS-C1713-IMPLANTABLE-ANCHOR-SCREW-BONE-FIXATION

    HCPCS C1713: Anchor/Screw for Bone or Soft Tissue Fixation (Implantable)

    HCPCS-C1714-TRANSLUMINAL-DIRECTIONAL-ATHERECTOMY-CATHETER

    HCPCS C1714: Catheter, transluminal atherectomy, directional

    HCPCS-C1715-BRACHYTHERAPY-NEEDLE

    HCPCS C1715: Brachytherapy Needle

    HCPCS-C1716-BRACHYTHERAPY-GOLD-198-SOURCE

    HCPCS C1716: Brachytherapy Source, Gold-198, Per Source

    HCPCS-C1717-HDR-BRACHYTHERAPY-IRIDIUM-192-SOURCE

    HCPCS C1717: HDR Iridium-192 Brachytherapy Source, Per Source

    HCPCS-C1719-BRACHYTHERAPY-IRIDIUM-192-SOURCE-NON-STRANDED

    HCPCS C1719: Brachytherapy Source, Iridium-192, Non-Stranded

    HCPCS-C1721-IMPLANTABLE-DUAL-CHAMBER-CARDIOVERTER-DEFIBRILLATOR

    HCPCS C1721: Cardioverter-Defibrillator, Dual Chamber (Implantable)

    HCPCS-C1724-ROTATIONAL-TRANSLUMINAL-ATHERECTOMY-CATHETER

    HCPCS Level II C1724: Rotational Transluminal Atherectomy Catheter

    HCPCS-C1725-TRANSLUMINAL-ANGIOPLASTY-CATHETER-NON-LASER

    HCPCS Level II C1725: Transluminal Angioplasty Catheter, Non-Laser

    HCPCS-C1726-NON-VASCULAR-BALLOON-DILATATION-CATHETER

    HCPCS C1726: Catheter, Balloon Dilatation, Non-Vascular

    Showing 1–10 of 603

    • More pages

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
    Published by

    Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.