2026 lower-extremity CPT crosswalk
The 37220–37235 lower-extremity revascularization codes are retired. The work is now reported from 37254–37299, organised by territory, then modality, then straightforward versus complex, with an “each additional vessel” add-on for every combination.
What changed
The old structure was organised primarily by territory and modality, with a single code per combination. The 2026 structure keeps territory and modality but adds two things: a complexity split on every family, and a consistent add-on for each additional vessel. It also adds an inframalleolar territory that did not previously have its own revascularization codes, and separate intravascular lithotripsy codes in the iliac and femoral/popliteal territories.
The practical effect is that documentation decides more than it used to. Under the old codes the modality and the vessel were usually enough. Now the record also has to support a complexity determination and an accurate count of vessels treated within each territory.
How to find the right family
Three questions, in order:
- Which territory? Iliac, femoral/popliteal, tibial/peroneal, or inframalleolar. Note that the femoral and popliteal arteries count as one vessel, while each tibial and peroneal vessel counts separately.
- Which modality? Angioplasty alone, stent, atherectomy with angioplasty, or atherectomy with stent. The atherectomy codes already include the angioplasty or stent done with them. Lithotripsy has its own code in the iliac and femoral/popliteal territories.
- Straightforward or complex? A coding determination from the CPT definitions, resting on what the note records about occlusion, lesion length, calcification and the techniques required.
Then add the matching “each additional vessel” code for every further vessel treated in that same territory.
The 2026 families in full
Iliac — 37254–37262
| Code | Descriptor |
|---|---|
| 37254 | transluminal angioplasty, straightforward |
| 37255 | transluminal angioplasty, straightforward, each additional vessel |
| 37256 | transluminal angioplasty, complex |
| 37257 | transluminal angioplasty, complex, each additional vessel |
| 37258 | transluminal stent placement, straightforward |
| 37259 | transluminal stent placement, straightforward, each additional vessel |
| 37260 | transluminal stent placement, complex |
| 37261 | transluminal stent placement, complex, each additional vessel |
| 37262 | intravascular lithotripsy, iliac; each vessel |
Femoral / popliteal — 37263–37279
| Code | Descriptor |
|---|---|
| 37263 | transluminal angioplasty, straightforward |
| 37264 | transluminal angioplasty, straightforward, each additional vessel |
| 37265 | transluminal angioplasty, complex |
| 37266 | transluminal angioplasty, complex, each additional vessel |
| 37267 | transluminal stent placement, straightforward |
| 37268 | transluminal stent placement, straightforward, each additional vessel |
| 37269 | transluminal stent placement, complex |
| 37270 | transluminal stent placement, complex, each additional vessel |
| 37271 | atherectomy with angioplasty, straightforward |
| 37272 | atherectomy with angioplasty, straightforward, each additional vessel |
| 37273 | atherectomy with angioplasty, complex |
| 37274 | atherectomy with angioplasty, complex, each additional vessel |
| 37275 | atherectomy with stent, straightforward |
| 37276 | atherectomy with stent, straightforward, each additional vessel |
| 37277 | atherectomy with stent, complex |
| 37278 | atherectomy with stent, complex, each additional vessel |
| 37279 | intravascular lithotripsy, femoral/popliteal; each vessel |
Tibial / peroneal — 37280–37295
| Code | Descriptor |
|---|---|
| 37280 | transluminal angioplasty, straightforward |
| 37281 | transluminal angioplasty, straightforward, each additional vessel |
| 37282 | transluminal angioplasty, complex |
| 37283 | transluminal angioplasty, complex, each additional vessel |
| 37284 | transluminal stent placement, straightforward |
| 37285 | transluminal stent placement, straightforward, each additional vessel |
| 37286 | transluminal stent placement, complex |
| 37287 | transluminal stent placement, complex, each additional vessel |
| 37288 | atherectomy with angioplasty, straightforward |
| 37289 | atherectomy with angioplasty, straightforward, each additional vessel |
| 37290 | atherectomy with angioplasty, complex |
| 37291 | atherectomy with angioplasty, complex, each additional vessel |
| 37292 | atherectomy with stent, straightforward |
| 37293 | atherectomy with stent, straightforward, each additional vessel |
| 37294 | atherectomy with stent, complex |
| 37295 | atherectomy with stent, complex, each additional vessel |
Inframalleolar — 37296–37299
| Code | Descriptor |
|---|---|
| 37296 | transluminal angioplasty, straightforward |
| 37297 | transluminal angioplasty, straightforward, each additional vessel |
| 37298 | transluminal angioplasty, complex |
| 37299 | transluminal angioplasty, complex, each additional vessel |
Related codes that have not moved
| Code | Descriptor |
|---|---|
| 37252 | Intravascular ultrasound, noncoronary vessel, initial vessel |
| 37253 | Intravascular ultrasound, noncoronary vessel, each additional vessel |
| 37211 | Transcatheter therapy, arterial infusion for thrombolysis, initial treatment day |
| 76937 | Ultrasound guidance for vascular access |
SCAI references
The Society for Cardiovascular Angiography & Interventions publishes the coding brochures most physicians already use for these codes. Read them directly; nothing here is reproduced from them, and SCAI does not endorse the codes this generator suggests.
- SCAI 2026 LER codes brochure (PDF)
- SCAI LER cheat sheet (PDF)
- SCAI 2026 iliac revascularization brochure (PDF)
- SCAI 2026 femoral/popliteal revascularization brochure (PDF)
- SCAI 2026 tibial/peroneal revascularization brochure (PDF)
Other references
- Society for Vascular Surgery — coding guidance published through Vascular Specialist
- Your device manufacturers’ peripheral coding guides
- Your Medicare Administrative Contractor’s local coverage articles
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