2026 Lower Extremity Revascularization Codes for Interventional Cardiology, Part 1-Dr. Osama Ibrahim slides

Dr. Osama Ibrahim slides

Pdf Summary

This document by Dr. Osama A. Ibrahim outlines the 2025 CPT (Current Procedural Terminology) code updates specific to the femoral-popliteal arterial segment, a historically high-volume area for endovascular interventions. The femoral-popliteal segment has been segmented into two zones for coding purposes: (1) the common femoral artery (CFA) and profunda femoris artery as one segment, and (2) the superficial femoral artery (SFA) and popliteal artery as another. This change moves away from previous bundled coding.<br /><br />Key distinctions in the new coding structure differentiate between straightforward cases (primarily stenosis) and complicated cases (primarily occlusions), impacting both procedure coding and relative value units (RVUs). The update includes new CPT codes for angioplasty, atherectomy, stenting, angiography, and lithotripsy, among others. The proposed RVUs for these are generally adjusted from prior values, reflecting procedure complexity and resource use.<br /><br />The document lists new coding for iliac, femoral-popliteal, tibial/peroneal, and inframalleolar procedures. Notably, straightforward femoral lesions typically involve short segments with minimal calcification or eccentric plaques, requiring less adjunct imaging or embolic protection. In contrast, complicated lesions often involve long segments, chronic total occlusions (CTOs), circumferential calcification, and increased use of intravascular lithotripsy (IVL), atherectomy, IVUS imaging, and distal embolization protection.<br /><br />Examples of lesion types illustrate these principles, emphasizing the varying treatment complexity between straightforward and complicated lesions in the femoral and popliteal arteries.<br /><br />Overall, these CPT changes allow more precise billing reflective of procedural complexity in femoral-popliteal interventions, with new codes and differentiated RVUs helping standardize reimbursement across specialties performing these common vascular treatments.

Keywords

2025 CPT code updates

femoral-popliteal arterial segment

endovascular interventions

common femoral artery (CFA)

profunda femoris artery

superficial femoral artery (SFA)

popliteal artery

procedure complexity

angioplasty and stenting codes

relative value units (RVUs)