2026 Coding Debrief: Lessons, Questions, and Next Steps-2026 LER Femoral Popliteal Brochure

2026 LER Femoral Popliteal Brochure

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This document outlines the CPT coding guidelines for lower extremity revascularization procedures within the femoral and popliteal vascular territories as endorsed by the Society for Cardiovascular Angiography and Interventions (SCAI). The codes cover various endovascular, open, or percutaneous interventions involving angioplasty, stent placement, atherectomy, and intravascular lithotripsy.<br /><br />Key CPT codes (37263-37279) specify procedures by lesion complexity—straightforward stenosis versus complex occlusion—and by vessel involvement: initial vessel or each additional vessel, with add-on codes used accordingly. The femoral and profunda femoris arteries count as a single vessel, as do the superficial femoral and popliteal arteries. Only one add-on code per leg in the territory may be reported, and stent placement codes are billed once even if multiple stents are used in the same vessel. Lesions crossing multiple territories treated similarly are reported with a single code; separate territories are reported individually. Each leg’s interventions are coded separately using modifier 59 to identify distinct procedures. Interventions are reported per vessel, coding for the most extensive procedure performed. For bilateral procedures, modifier 50 is applied to base codes, and add-on codes are reported twice.<br /><br />Lower extremity revascularization services include arterial access and catheterization, lesion crossing, radiologic supervision and interpretation, embolic protection, arteriotomy closure, and completion imaging. Specific imaging codes (e.g., 36140 series, 76000 series) performed on the treated vessel through the same access can be reported together. Procedures not crossing lesions should be billed as diagnostic angiography. The intravascular lithotripsy code (37279) may be reported up to twice per leg.<br /><br />These guidelines serve as a consensus for proper CPT code use based on limited case information, meant for general reference rather than clinical or legal counsel. For individualized coding or reimbursement decisions, consultation with professional coders or legal advisors is recommended.

Keywords

CPT coding

lower extremity revascularization

femoral artery

popliteal artery

endovascular interventions

angioplasty

stent placement

atherectomy

calcium

laser

orbital

plaque

intravascular lithotripsy

modifier 59