2026 Lower Extremity Revascularization Codes for Interventional Cardiology, Part 2-Slides: Dr. Jay Giri

Slides: Dr. Jay Giri

Pdf Summary

The Society for Cardiovascular Angiography and Interventions (SCAI) presents Part 2 of the 2026 coding guidelines for lower extremity interventions in cardiology, focusing on tibio-peroneal artery procedures. Dr. Jay Giri from the University of Pennsylvania provides expertise on interventional cardiology and vascular medicine.<br /><br />Coding for tibio-peroneal interventions uses primary/base codes and add-on codes corresponding to the type of procedure (angioplasty, stenting, atherectomy) and the number of vessels treated. Primary codes (e.g., 37280 for angioplasty) apply per treated vascular territory, with a maximum of one primary code per territory; the tibioperoneal trunk is only reported separately if it is the only vessel treated. Add-on codes are used to bill for additional vessels treated within the same territory, limited to two per leg. Modifiers 50 (bilateral primary codes) and 59 (bilateral add-on codes) are employed to indicate bilateral procedures during the same session.<br /><br />A clinical vignette illustrates an intervention for a 57-year-old man with chronic limb ischemia, highlighting the use of retrograde recanalization and angioplasty guided by angiosome principles, resulting in sustained clinical improvement despite comorbidities.<br /><br />Hospital outpatient payments for tibial-peroneal interventions are noted to increase modestly from 2025 to 2026 across various service sites including hospital outpatient departments, ambulatory surgery centers (ASC), office-based labs (OBL), and physician services. For example, hospital outpatient maximum payments rise from $17,957 to $18,791, and OBL payments increase from $10,596 to $13,233.<br /><br />This educational content is supported by industry leaders such as Boston Scientific, Cordis, Philips, Shockwave Medical, and W. L. Gore & Associates, aiming to guide accurate coding and reimbursement strategies for endovascular lower extremity procedures in cardiology.

Keywords

SCAI

2026 coding guidelines

lower extremity interventions

tibio-peroneal artery

interventional cardiology

angioplasty coding

stenting codes

atherectomy codes

hospital outpatient payments

endovascular procedures