**Vascular Stents & Bypass Procedures: Comprehensive CPT Coding Guide**

Introduction

Vascular stents and bypass procedures are used to treat arterial blockages and improve blood flow. Proper CPT coding ensures accurate reimbursement and prevents denials due to bundling or incorrect modifier use. This guide covers key CPT codes for endovascular stent placement, open surgical bypass, and related procedures, along with billing guidelines, modifier use, and a final reference table with CPT descriptions and RVUs.

Understanding Vascular Stents & Bypass Coding

  • Endovascular stents – Placed inside an artery via catheterization to keep it open.
  • Bypass graft procedures – Involve surgically redirecting blood flow using a graft.
  • Percutaneous transluminal angioplasty (PTA) – A minimally invasive technique to widen blocked vessels.

CPT Codes for Vascular Stents & Bypass Procedures

Endovascular Stent Placement CPT Codes

  • 37236 – Percutaneous stent placement, first artery.
  • 37237 – Each additional artery (add-on code).
  • 37238 – Iliac artery stent placement, initial vessel.
  • 37239 – Iliac artery stent placement, each additional vessel.
  • 34701 – Endovascular repair of infrarenal abdominal aorta.
  • 34705 – Endovascular repair of iliac artery.

Open Surgical Bypass CPT Codes

  • 35500 – Harvest of upper extremity vein for bypass.
  • 35556 – Bypass graft, aorto-bifemoral.
  • 35566 – Bypass graft, femoral-popliteal.
  • 35583 – Bypass graft, axillary-femoral.
  • 35661 – Bypass graft, aortic to femoral.

Percutaneous Transluminal Angioplasty (PTA) CPT Codes

  • 37246 – PTA, initial vessel.
  • 37247 – PTA, each additional vessel.
  • 35471 – PTA of renal artery.
  • 35472 – PTA of lower extremity.

Billing Guidelines & Modifier Usage

  • Common Modifiers:

    • -26 – Professional component (physician’s interpretation).
    • -TC – Technical component (equipment, technician use).
    • -59 – Distinct procedural service (if multiple interventions are performed).

  • Bundling Considerations:

    • Stent placement codes (37236, 37237) should not be billed separately from PTA codes (37246, 37247) in the same vessel.
    • Bypass procedures (35556–35661) are considered major surgeries and should not be reported with PTA or stent placement in the same vessel.

Common Denials & How to Avoid Them

  • Medical Necessity Denials: Ensure documentation includes angiography findings indicating severe stenosis or occlusion.
  • Bundling Issues: Verify National Correct Coding Initiative (NCCI) edits to determine if procedures should be reported separately.
  • Modifier Use Issues: Append -59 or -XU modifiers correctly when multiple procedures are performed on different vessels.

Final CPT Code Table: Descriptions & RVUs

CPT Code Description RVU
37236 Percutaneous stent placement, first artery 14.20
37237 Percutaneous stent placement, each additional artery 7.80
37238 Iliac artery stent placement, initial vessel 15.10
37239 Iliac artery stent placement, each additional vessel 8.25
34701 Endovascular repair of infrarenal abdominal aorta 20.40
34705 Endovascular repair of iliac artery 18.75
35500 Harvest of upper extremity vein for bypass 6.30
35556 Bypass graft, aorto-bifemoral 22.90
35566 Bypass graft, femoral-popliteal 19.80
35583 Bypass graft, axillary-femoral 21.30
35661 Bypass graft, aortic to femoral 23.50
37246 PTA, initial vessel 12.75
37247 PTA, each additional vessel 6.50
35471 PTA of renal artery 13.40
35472 PTA of lower extremity 14.10

Conclusion

Accurate CPT coding for vascular stents and bypass procedures is essential for maximizing reimbursement and preventing denials. Understanding bundling rules, modifier application, and payer-specific guidelines will help ensure accurate claims.

If this guide was useful, check out our other vascular CPT coding guides on dialysis access, carotid stenting, and peripheral interventions!