Summary & Overview
HCPCS C9773: Tibial/Peroneal Artery Revascularization with Lithotripsy and Stent
HCPCS Level II code C9773 represents combined revascularization procedures of the tibial and peroneal arteries performed endovascularly, percutaneously, or via open approaches that include intravascular lithotripsy and transluminal stent placement, with angioplasty included when performed. This code captures a complex, contemporary limb-revascularization technique aimed at treating calcified distal lower-extremity arterial disease and is relevant to vascular surgeons, interventional radiologists, and health plans managing high-acuity peripheral artery disease care. Nationally, the code matters because it codifies advanced intravascular lithotripsy plus stenting approaches distinct from standalone angioplasty or stent-only interventions, affecting coverage, prior authorization, and payment pathways across public and commercial payers.
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 for the procedure, expected sites of service, and typical service classification. The publication provides benchmarks and coding guidance relevant to billing and claims submission, summarizes payer coverage considerations, and flags policy or coding updates where available. Data limitations or unavailable items from the input are noted explicitly. This national-level summary is intended for clinicians, coding staff, and payer policy teams seeking clarity on the clinical scope and billing classification of C9773.
Billing Code Overview
HCPCS Level II code C9773 describes revascularization, endovascular, open or percutaneous, of the tibial/peroneal artery(ies) performed with intravascular lithotripsy and transluminal stent placement(s); the code includes angioplasty within the same vessel(s) when performed. This procedure is a combined arterial revascularization intervention addressing distal lower-extremity tibial and peroneal vessels using intravascular lithotripsy to modify calcified plaque and placement of one or more transluminal stents.
Service type: Endovascular and percutaneous arterial revascularization with adjunctive intravascular lithotripsy and stent placement
Typical site of service: Hospital outpatient department, ambulatory surgery center, or inpatient vascular surgery/interventional radiology setting
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with diabetes mellitus and peripheral artery disease presents with rest pain and nonhealing forefoot ulceration. Noninvasive testing and diagnostic angiography reveal severe, calcified stenoses of the tibial and peroneal arteries limiting distal perfusion. The vascular surgery or interventional cardiology team schedules endovascular revascularization using intravascular lithotripsy to fracture medial and intimal arterial calcification, followed by transluminal angioplasty and placement of drug-eluting or bare-metal stents in the affected tibial/peroneal segments. The procedure typically occurs in an endovascular suite or hybrid operating room under moderate sedation or general anesthesia. Preprocedural workflow includes vascular lab testing, medication reconciliation (antiplatelet and anticoagulant management), informed consent, and review of imaging. Intra-procedural steps include arterial access (commonly femoral or antegrade tibial access), crossing lesions with guidewires, intravascular lithotripsy balloon activation, balloon angioplasty, stent deployment, and completion angiography to confirm perfusion. Postprocedural care includes access site hemostasis, monitoring for complications (bleeding, thrombosis, embolization), antiplatelet therapy, wound care for ulcers, and follow-up vascular imaging or ankle-brachial indices to assess clinical improvement.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default billing indicator (no modifier) | Use when no other modifier applies and standard billing is appropriate |