2026 Lower Extremity Revascularization Codes for Interventional Cardiology, Part 1-2026 LER Femoral Popliteal Brochure

2026 LER Femoral Popliteal Brochure

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This document provides detailed coding guidelines from the Society for Cardiovascular Angiography and Interventions (SCAI) for lower extremity revascularization procedures targeting the femoral and popliteal arterial territories according to the 2026 CPT codes. The revascularization methods include endovascular, open, or percutaneous approaches with techniques such as transluminal angioplasty, stent placement, atherectomy, and intravascular lithotripsy.<br /><br />Key CPT codes (37263-37279) are organized by procedure type (angioplasty, stent, atherectomy, combined stent/atherectomy, and lithotripsy), lesion complexity (straightforward vs. complex), and whether the procedure is performed on the initial vessel or additional vessels in the same arterial territory. Stent placement codes include angioplasty as part of the procedure if performed. Separate codes exist for each vessel treated, with add-on codes used for additional vessels within the femoral/popliteal territory, respecting a maximum of one add-on code per leg. Modifiers (e.g., 50 for bilateral procedures, 59 to denote distinct procedures per leg) guide appropriate billing.<br /><br />The femoral/popliteal territory considers the common femoral and profunda femoris as a single vessel and the superficial femoral and popliteal as another single vessel. Lesions that cross territories but are treated with a single therapy should be reported as one code. Interventions are coded per vessel, not per lesion, with the most comprehensive service performed taking precedence. Procedures not crossing lesions should be billed as diagnostic angiography, and intravascular lithotripsy codes may be reported twice per leg.<br /><br />Included is the scope of services covered by the revascularization codes: access and selective catheterization, lesion crossing, embolic protection, arteriotomy closure, and imaging documentation, along with radiologic supervision and interpretation. The document references the AMA's CPT 2026 Professional Edition and CPT Changes 2026 and contains disclaimers emphasizing the informational nature of the guidance without offering clinical or legal advice.

Keywords

SCAI coding guidelines

lower extremity revascularization

femoral artery

popliteal artery

2026 CPT codes

angioplasty

stent placement

atherectomy

calcium

laser

orbital

plaque

intravascular lithotripsy

procedure billing modifiers