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    v1.0.30
    OpenPayerBilling CodesOther ServicesHCPCS hcpcs-level-ii-m1503-vascular-surgery-mips-value-pathway
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    HCPCS Level II M1503: Vascular Surgery MIPS Value Pathway

    HCPCS Level II code M1503 denotes the Vascular Surgery MIPS Value Pathway, identifying services tied to performance measurement and reporting for vascular surgery; the service type is quality measurement and reporting and the typical site of service is ambulatory surgical centers or hospital outpatient departments related to vascular specialty care.

    For related coverage guidance, see recent payer policy updates: Hospital Beds Corporate Medical Policy, Patient Lifts, Home Non-Invasive Positive Pressure Ventilation (NIPPV) Devices for Respiratory Insufficiency and Failure.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 68-year-old male with progressive claudication and documented peripheral arterial disease presents to a vascular surgery clinic for enrollment in a Vascular Surgery MIPS Value Pathway quality reporting program. He has a history of diabetes mellitus type 2, hypertension, and hyperlipidemia. After noninvasive testing including arterial duplex ultrasound and ankle-brachial index confirming significant femoropopliteal disease, the patient is scheduled for an outpatient endovascular intervention by a vascular surgeon.

    The clinical workflow includes pre-procedure evaluation (history, focused vascular exam, medication reconciliation, informed consent), diagnostic angiography with possible percutaneous transluminal angioplasty ± stent placement, intra-procedural documentation of lesion characteristics and devices used, post-procedure monitoring for access site complications, discharge instructions including antiplatelet therapy and wound care, and reporting of MIPS/VBP performance measures and quality metrics.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    37224Revascularization, endovascular, percutaneous, open or percutaneous, femoral-popliteal artery, single vessel; with transluminal angioplastyCommonly used for percutaneous transluminal angioplasty of femoropopliteal lesions performed during the endovascular intervention.
    36215Selective catheter placement, arterial system; each first-order thoracic branch, neck, abdominal, or visceral artery, and catheter angiography of extremity arteries when performedUsed for diagnostic selective catheterization during peripheral angiography.
    35476Reconstruction, fem-pop bypass using autogenous vein, single segment (includes anastomoses)Related open surgical revascularization alternative when endovascular therapy is not feasible.
    37226Revascularization, endovascular, percutaneous, femoropopliteal; with stent placementUsed when stent placement is performed during the percutaneous femoropopliteal intervention.
    93925Duplex scan of arterial inflow and outflow limbs with bidirectional waveforms (arterial study) for bypass grafts, pre- and post-operative comparisonUseful for pre-procedure mapping and post-procedure surveillance of grafts and treated segments.

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    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…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…
    77Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…
    24Modifier 24 denotes an unrelated evaluation and management (E/M) service performed by the same physician or qualified healthcare professional during a postoperative global period. Per CPT guidance,…- Use modifier 24 when you report an evaluation and management (E/M) service performed by the same physician or same-specialty group during a procedure’s postoperative global period that is unrelated…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207K00000X
    2080P0006X
    207L00000X
    261QF0400X
    251C00000X
    2279H0200X
    225XH1300X
    1835N0905X

    Related ICD-10-CM Codes

    25 rows

    ICD-10-CM CodeDescription
    E11.51Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene
    E11.52Type 2 diabetes mellitus with diabetic peripheral angiopathy with gangrene
    E78.5Hyperlipidemia, unspecified
    I70.0Atherosclerosis of aorta
    I70.201Unspecified atherosclerosis of native arteries of extremities, right leg
    I70.211Atherosclerosis of native arteries of extremities with intermittent claudication, right leg
    I70.221Atherosclerosis of native arteries of extremities with rest pain, right leg
    I70.223Atherosclerosis of native arteries of extremities with rest pain, bilateral legs
    I70.231Atherosclerosis of native arteries of right leg with ulceration of thigh
    I70.241Atherosclerosis of native arteries of left leg with ulceration of thigh

    Showing 1–10 of 25

    Related Payer Policy Updates

    Specialty: Durable Medical Equipment (DME)1 / 2

    10 rows

    PolicyPayerEffective Date
    Hospital Beds Corporate Medical Policybcbsvermont2027-01-01
    Patient Liftsuniverahealthcare2026-11-16
    Home Non-Invasive Positive Pressure Ventilation (NIPPV) Devices for Respiratory Insufficiency and Failureexcellus_health_plan_inc2026-10-15
    Positive Airway Pressure Devices for Pulmonary Disorders Continued RentalCareSource Georgia2026-10-01
    Bone Growth StimulatorsProvidence Health Plan2026-10-01
    Durable Medical Equipment (DME) Medical Necessity and CoverageMass General Brigham Health Plan2026-10-01
    Speech Generating DevicesMass General Brigham Health Plan2026-10-01
    Interferential Stimulation Devices (for home use)Moda Health2026-10-01
    Durable Medical Equipment (DME): Tumor Treating Fields (Alternating Electric Field Therapy) Medical GuidelineWPS Health Insurance2026-10-01
    Durable Medical Equipment (DME): Bone Growth Stimulators Medical GuidelineWPS Health Insurance2026-10-01

    Related Codes

    HCPCS-LEVEL-II-M1252-AMBULATORY-PALLIATIVE-CARE-SURVEY-NONCOMPLETION

    HCPCS M1252: Ambulatory Palliative Care Patient Experience Survey Incomplete

    HCPCS-LEVEL-II-M1255-POSITIVE-PREGNANCY-TEST-NON-OB-VISIT

    HCPCS Level II M1255: Visit with Positive Pregnancy Test, Not Established OB

    HCPCS-LEVEL-II-M1278-ELEVATED-BLOOD-PRESSURE-WITH-DOCUMENTED-FOLLOW-UP

    HCPCS Level II M1278: Elevated or Hypertensive Blood Pressure Reading Documented

    HCPCS-LEVEL-II-M1292-FRAILTY-WITH-ADVANCED-ILLNESS-66-PLUS

    HCPCS M1292: Frailty with Advanced Illness, Age 66 and Older

    HCPCS-LEVEL-II-M1300-INFLUENZA-IMMUNIZATION-NOT-ADMINISTERED

    HCPCS Level II M1300: Influenza Immunization Not Administered, Documented Reason

    HCPCS-LEVEL-II-M1326-HYPOTONY-EVALUATION-MANAGEMENT

    HCPCS Level II M1326: Patients with a Diagnosis of Hypotony

    HCPCS-LEVEL-II-M1356-PATIENTS-WHO-DIED-DURING-MEASUREMENT-PERIOD

    HCPCS Level II M1356: Patients Who Died During Measurement Period

    HCPCS-LEVEL-II-M1375-RA-ADDITIONAL-ENCOUNTER-90-DAYS

    HCPCS Level II M1375: Additional Rheumatoid Arthritis Encounter

    HCPCS-LEVEL-II-M1384-PATIENTS-DIED-PERFORMANCE-PERIOD

    HCPCS Level II M1384: Patient Death During Performance Period

    HCPCS-LEVEL-II-M1490-PATIENT-STATUS-NOT-DOCUMENTED

    HCPCS Level II M1490: Patient Status Not Documented

    Showing 1–10 of 356

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    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.
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