By Stephanie Smith, RHIA
Effective Jan. 1, 2026, the CPT codes for lower extremity revascularization have changed. They are organized by the artery as well as straightforward complexity with stenosis (some blood flow) or complex with occlusion (no blood flow). This will impact the documentation needed in operative notes for these procedures.
The new codes are below:
| TERRITORY | ILIAC | FEMORAL AND POPLITEAL | TIBIAL and PERONEAL | INFRAMALLEOLAR | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Lesion type, vessel | Angioplasty | Stent | Angioplasty | Stent | Atherectomy | Stent and Atherectomy | Angioplasty | Stent | Atherectomy | Stent and Atherectomy | Angioplasty |
| Straightforward, initial | 37254 | 37258 | 37263 | 37267 | 37271 | 37275 | 37280 | 37284 | 37288 | 37292 | 37296 |
| Straightforward, each additional | 37255 | 37259 | 37264 | 37268 | 37272 | 37276 | 37281 | 37285 | 37289 | 37293 | 37297 |
| Complex, initial | 37256 | 37260 | 37265 | 37269 | 37273 | 37277 | 37282 | 37286 | 37290 | 37294 | 37298 |
| Complex each additional | 37257 | 37261 | 37266 | 37270 | 37274 | 37278 | 37283 | 37287 | 37291 | 37295 | 37299 |
The following will need to be documented in operative notes:
Lesion type and complexity: Identify clearly whether you treated a stenosis with some blood flow (straightforward) or an occlusion with no blood flow (complex); the complexity determines whether you report “initial” vs “each additional” vessel in that territory.
Vascular territory: Specify iliac, femoral/popliteal, tibial/peroneal, or inframalleolar; code selection is territory specific.
Treatment performed: Document angioplasty, stent, atherectomy, and combinations (e.g., stent + atherectomy) explicitly; codes are grouped by treatment type.
Source: AMA CPT Professional Edition 2026
We invite you to contact us to schedule large group, small group, or 1:1 training. We are dedicated to the education and success of all UTMB providers. Please contact the Revenue Cycle Coding Education Team at codinged@UTMB.EDU to ask questions or schedule a meeting. We are here to help!