2026 Lower Extremity Revascularization Codes for Interventional Cardiology, Part 1-LER Cheat Sheet

LER Cheat Sheet

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This document is a comprehensive coding guide for Lower Extremity Revascularization (LER), focusing on vascular territories and corresponding CPT codes for procedures such as angioplasty, stent placement, atherectomy, and lithotripsy. It categorizes the lower extremity arterial system into four main vascular territories and specifies which CPT codes apply for initial treatment and additional vessels within those territories.<br /><br />The four vascular territories detailed are:<br /><br />1. Iliac Territory: Includes common, internal, and external iliac arteries. Initial artery treatment codes include 37254, 37256, 37258, and 37260. Up to two add-on codes (37255, 37257, 37259, 37261) can be used for additional vessels. Lithotripsy (code 37262) may be reported up to three times per leg. Iliac atherectomy uses code 0238T.<br /><br />2. Femoral/Popliteal Territory: Covers common femoral, profunda femoris (treated as a single vessel), superficial femoral, and popliteal (also treated as a single vessel). Initial artery codes range from 37263 to 37277, with one add-on code allowed per extremity. Lithotripsy (code 37279) can be reported twice per leg.<br /><br />3. Tibial/Peroneal Territory: Includes anterior tibial, posterior tibial, and peroneal arteries, with tibioperoneal trunk reported only if solely treated. Uses initial artery codes 37280 to 37294, with up to two add-on codes allowed.<br /><br />4. Inframalleolar Territory: Includes dorsalis pedis and plantar arteries. Pedal arch is reported only if alone treated. Uses codes 37296 and 37298 for initial artery treatment and one add-on code permitted.<br /><br />The guide emphasizes using the code for the most complex service performed when multiple lesions exist, and prohibits add-on codes for multiple lesions within the same vessel. It also provides cross-reference tables indicating deletion of older codes (e.g., 37220-37235) replaced by new 2026 codes.<br /><br />The document concludes with disclaimers about the use of these codes for reimbursement and advises consultation with legal counsel for coding and billing decisions. The reference source is the American Medical Association's CPT 2026 edition.

Keywords

Lower Extremity Revascularization

LER coding guide

vascular territories

CPT codes

angioplasty

stent placement

atherectomy

calcium

laser

orbital

plaque

lithotripsy

iliac territory

femoral popliteal territory