Summary & Overview
HCPCS C9766: Lower Extremity Revascularization with Lithotripsy and Atherectomy
HCPCS Level II code C9766 represents combined revascularization procedures on lower extremity arteries (excluding tibial/peroneal vessels) that use intravascular lithotripsy and atherectomy, and may include angioplasty in the same vessel(s). This code captures complex peripheral arterial interventions that target calcified or obstructive lesions not involving tibial or peroneal segments. Nationally, such procedures are significant for vascular specialists, hospitals, and payers due to procedure complexity, device use, and implications for care pathways and costs.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, the typical settings where the service is delivered, and what the code denotes procedurally. The publication outlines expected benchmarks and coverage considerations, highlights policy-relevant updates impacting billing and claims, and situates the code within peripheral vascular care workflows. Where input data is not provided, the report notes that specific fields are unavailable. This summary provides a national perspective intended for coding professionals, revenue cycle staff, and clinical leaders seeking clear, actionable description of HCPCS Level II code C9766 and its role in peripheral arterial revascularization.
Billing Code Overview
HCPCS Level II code C9766 describes revascularization of lower extremity artery(ies) excluding tibial/peroneal segments performed by endovascular, open, or percutaneous approaches. The procedure specifically includes intravascular lithotripsy and atherectomy, and includes angioplasty within the same vessel(s) when performed as part of the same encounter.
Service type: Combined endovascular/open peripheral arterial revascularization with adjunctive intravascular lithotripsy and atherectomy
Typical site of service: Hospital outpatient departments, ambulatory surgical centers, and inpatient operating rooms
Clinical & Coding Specifications
Clinical Context
A 72-year-old male with a history of peripheral arterial disease (PAD), diabetes mellitus, and progressive right calf claudication presents with worsening exertional leg pain and nonhealing forefoot ulceration. Noninvasive testing (ABI and arterial duplex) demonstrates significant inflow disease of the iliofemoral and femoropopliteal segments with focal, heavily calcified atherosclerotic lesions above the tibial/peroneal level. The vascular surgery/endovascular team schedules an endovascular revascularization procedure targeting the lower extremity artery(ies) above the tibial/distal segment. In the angiography suite under conscious sedation or general anesthesia, diagnostic angiography guides lesion crossing. Intravascular lithotripsy is used to fracture concentric calcified plaque, followed by atherectomy to debulk and modify lesion morphology, and adjunctive angioplasty (and/or stenting if indicated) is performed within the same treated vessel(s). The procedure may occur in an outpatient ambulatory surgical center or inpatient hospital operating room depending on clinical status, comorbidities, and payor requirements. Typical documentation includes pre-procedure indications, targeted vessel(s), lesion morphology, devices used (IVL catheter, atherectomy system, balloons/stents), intra-procedural angiographic results, anesthesia type, total contrast and fluoroscopy time, and post-procedure plan for antiplatelet therapy and wound care.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Default when no additional modifier applies |