Bilateral Straightforward: Angioplasty

Question:

What CPT codes would you use for bilateral straightforward angioplasty of the right and left external iliac arteries using one access site? Can you use 37254-50 or would it be 37254 for the initial vessel and 37255 for the vessel on the contralateral side?

Answer:

For bilateral straightforward angioplasty of the external iliac arteries (EIA) performed via a single access site, the correct coding approach in 2026 is to use the initial vessel code for each side, rather than using the "additional vessel" add-on code for the contralateral iliac artery.

Under current CPT guidelines for lower extremity revascularization procedures are reported based on anatomical vascular territories (Iliac, Femoral/Popliteal, Tibial/Peroneal, and Inframalleolar) and are typically unilateral.

The appropriate code for a "straightforward" angioplasty in the iliac territory is 37254 (initial vessel) and 37255 (each additional ipsilateral vessel). Because you are treating two different anatomical sides (Right and Left), both are considered "initial" vessels for their respective territories.

Primary Code: 37254 (Iliac territory angioplasty, straightforward, initial vessel)

Append Modifier 50 to the primary code (37254-50) or report as 37254-RT and 37254-LT, depending on payer preference.

*This response is based on the best information available as of 08/13/26.