CPT Code 37227 | Description & Clinical Information
CPT 37227 describes a procedure in which the provider restores blood supply to a narrowed femoral or popliteal artery through an endovascular, open, or percutaneous approach, using transluminal stent placement and atherectomy to remove plaque from the blood vessel, and including an angioplasty procedure within the same vessel.
Official Description
The CPT book defines CPT code 37227 as: “Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal stent placement(s) and atherectomy, includes angioplasty within the same vessel, when performed”.
Billing Guidelines
Do not code 0505T along with CPT codes 37224, 37225, 37226, and 37227 for procedures performed within the femoral-popliteal segment.
Clinical Information
The procedure described by CPT code 37227 is a minimally invasive endovascular procedure, used to treat an area of arterial occlusion. It is typically performed when other interventions, such as medication or lifestyle changes, have proven to be unsuccessful or when a patient is at high risk for complications.
There are two approaches that a provider can take when performing this procedure: open or percutaneous. In an open approach, the provider makes an incision over the femoral triangle, an anatomical region in the upper inner thigh, to access the femoral artery. If the occlusion is in the popliteal artery, the incision is extended through the femoral triangle and down to the back of the knee to expose the stenosed, or narrowed, popliteal artery. In a percutaneous approach, the provider punctures the artery through the skin using a needle to reach the area of occlusion.
Once the provider has accessed the obstruction, a vascular clamp is used to grasp the artery, and an arterial irrigation is performed by infusing a heparin saline into the occluded artery. Next, a rotational atherectomy device, also known as a burr catheter, is inserted under radiological guidance to the site of treatment with guidance from a guidewire. The burr catheter dislodges the atherosclerotic plaque from the inner wall of the diseased artery.
After the plaque is removed, the provider withdraws the atherectomy catheter and inserts a catheter stent system into the same artery. The stent is placed at the site of occlusion and expanded against the wall of the lumen to open and recanalize the vessel. To confirm the patency of the treated vessel, the provider may use an angioscope to check the extent of revascularization.
Finally, the catheter stent system is withdrawn through the access site, and bleeding is stopped by applying a compression bandage over the puncture location when using the percutaneous approach or suturing the soft tissue layers in an open procedure.
Overall, CPT code 37227 is an effective and minimally invasive way to treat arterial occlusions, helping patients reduce symptoms and prevent more serious health complications.
Return to all the CPT codes for endovascular revascularization.
