37258 Arterial stenting Medicare reimbursement rates in Illinois

This code covers endovascular stent treatment of a straightforward lesion in an infrapopliteal artery, such as an anterior tibial, posterior tibial, or peroneal artery. A vascular surgeon, interventional radiologist, or interventional cardiologist may perform the catheter-based procedure for peripheral arterial disease, including limb ischemia, in a hospital or other procedural setting. The code identifies treatment of the initial vessel; the code family distinguishes straightforward from complex lesions and initial from additional vessels.

Report the code when the treated lesion and vessel meet the straightforward-lesion criteria and a stent is placed. The procedure report should identify the target artery, lesion, treatment performed, and whether it was the initial vessel treated. Same-day preoperative and postoperative care is included in the 0-day global period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures at 50%. Modifier 50 for a bilateral procedure is paid at 150%. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.