Summary & Overview
HCPCS C9772: Tibial/Peroneal Revascularization with Intravascular Lithotripsy
HCPCS Level II code C9772 represents tibial and peroneal artery revascularization using intravascular lithotripsy, including angioplasty in the same vessel when performed. The code covers endovascular, open, or percutaneous approaches that specifically incorporate lithotripsy to treat calcified lesions, an important advance in peripheral arterial disease care that can affect limb salvage and procedural planning across the country. This code matters nationally as intravascular lithotripsy becomes more widely used for calcified peripheral lesions and payers update coverage and reimbursement guidance.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, expected service settings, typical billing modifiers, payer coverage considerations, and benchmark topics relevant to facilities and clinicians performing peripheral revascularization. The publication summarizes coding scope, describes where the procedure is typically performed (hospital outpatient departments, ambulatory surgery centers, catheterization laboratories), and outlines the kinds of data and benchmarks readers can expect to review, including utilization patterns, reimbursement ranges, and policy updates where available. Data not available in the input are explicitly noted, and the focus remains national in scope rather than state-specific.
Billing Code Overview
HCPCS Level II code C9772 describes revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies), with intravascular lithotripsy, includes angioplasty within the same vessel(s), when performed. This procedure group involves mechanical and catheter-based techniques to restore blood flow in the tibial and peroneal arteries, incorporating intravascular lithotripsy to fracture calcified plaque and often followed by angioplasty in the treated vessel.
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Service type: Endovascular and/or percutaneous revascularization with intravascular lithotripsy and angioplasty
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Typical site of service: Hospital outpatient department, ambulatory surgery center, or catheterization laboratory
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 68-year-old with long-standing diabetes mellitus and peripheral arterial disease presenting with rest pain, non-healing forefoot ulceration, or lifestyle-limiting claudication. Noninvasive testing (ankle-brachial index, toe pressures, arterial duplex) demonstrates significant tibial/peroneal artery stenosis or heavily calcified lesions limiting balloon angioplasty. The vascular surgery or interventional cardiology team evaluates angiographic findings in the cath lab or hybrid operating room. Under conscious sedation or general anesthesia, arterial access is obtained (commonly antegrade femoral or retrograde tibial/pedal). Diagnostic angiography localizes the target tibial/peroneal lesion(s). Intravascular lithotripsy (IVL) is performed using an IVL balloon catheter to fracture intimal and medial calcification, followed by adjunctive angioplasty and, when indicated, stent placement or atherectomy. Hemostasis is achieved with manual compression, closure device, or surgical repair as appropriate. Typical sites of service include an outpatient endovascular suite, hospital-based catheterization laboratory, same-day surgery unit, or inpatient operating room for complex cases. Post-procedure monitoring includes vascular checks, access site observation, and secondary prevention measures (antiplatelet therapy, risk factor modification).
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Standard reporting without additional modifiers when none apply |