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Code deleted, see 37220, 37221, 37222, 37223, 37224, 37225, 37226, 37227.

Official Description

Transluminal balloon angioplasty, open; iliac

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 35454 refers to an open transluminal balloon angioplasty specifically targeting the iliac artery. This medical intervention is performed to alleviate blockages or narrowing within the iliac artery, which can impede blood flow and lead to various complications. During the procedure, the physician begins by preparing the skin over the access artery, followed by making an incision to expose the artery. A small nick is made in the artery to facilitate the placement of a sheath, which allows for the introduction of a guidewire. This guidewire is then carefully advanced through the access artery into the occluded iliac artery. A catheter equipped with a balloon tip is subsequently maneuvered over the guidewire to the site of the blockage. Once positioned, the balloon is inflated, exerting pressure on the plaque buildup and compressing it against the arterial wall, thereby widening the artery and restoring blood flow. The inflation of the balloon may be repeated multiple times to achieve optimal results. After the angioplasty, the angioplasty catheter is exchanged for a guidewire, and an angiography catheter is introduced to assess the success of the procedure. Contrast material is injected, and a completion angiography is performed to confirm that the artery is patent, meaning it is open and unobstructed. Finally, the angiography catheter is removed, and the access artery is repaired before closing the skin incision. This comprehensive approach ensures that the iliac artery is effectively treated, promoting improved circulation and reducing the risk of further complications.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure of open transluminal balloon angioplasty of the iliac artery is indicated for patients experiencing specific conditions that necessitate intervention to restore blood flow. These indications may include:

  • Peripheral Artery Disease (PAD) - A condition characterized by narrowed arteries reducing blood flow to the limbs, often leading to pain and mobility issues.
  • Intermittent Claudication - Pain or cramping in the legs or buttocks during physical activities, such as walking, due to insufficient blood flow.
  • Critical Limb Ischemia - A severe obstruction of blood flow to the extremities, which can lead to pain at rest, non-healing wounds, or gangrene.
  • Arterial Occlusion - Blockage of the iliac artery due to plaque buildup, which can significantly impair blood circulation.

2. Procedure

The open transluminal balloon angioplasty procedure involves several critical steps to ensure effective treatment of the iliac artery. The process begins with the physician preparing the skin over the access artery, ensuring a sterile environment to minimize the risk of infection. Following this, an incision is made to expose the artery, allowing direct access for the subsequent steps. A small nick is made in the artery to facilitate the insertion of a sheath, which serves as a conduit for the guidewire.

  • Step 1: The physician makes an incision in the skin over the iliac artery, exposing the artery for access.
  • Step 2: A nick is created in the artery, and a sheath is placed to allow for the introduction of a guidewire.
  • Step 3: A guidewire is inserted through the sheath and advanced into the occluded iliac artery, navigating past the blockage.
  • Step 4: A catheter with a balloon tip is then advanced over the guidewire to the site of the occlusion.
  • Step 5: The balloon is inflated at the site of the blockage, compressing the plaque against the arterial wall to widen the artery.
  • Step 6: The balloon may be inflated multiple times to achieve the desired dilation of the artery.
  • Step 7: After the angioplasty, the angioplasty catheter is exchanged for a guidewire, allowing for the next step.
  • Step 8: An angiography catheter is advanced over the guidewire, and the guidewire is then withdrawn.
  • Step 9: Contrast material is injected through the angiography catheter, and a completion angiography is performed to assess the patency of the artery.
  • Step 10: Finally, the angiography catheter is withdrawn, the access artery is repaired, and the skin incision is closed.

3. Post-Procedure

Post-procedure care following an open transluminal balloon angioplasty of the iliac artery typically involves monitoring the patient for any immediate complications, such as bleeding or infection at the incision site. Patients may be advised to rest and limit physical activity for a specified period to promote healing. Follow-up appointments are essential to assess the success of the procedure and to monitor the patient's recovery. Additionally, patients may be prescribed medications to manage any underlying conditions, such as anticoagulants to prevent blood clots, and lifestyle modifications may be recommended to improve overall vascular health.

Short Descr REPAIR ARTERIAL BLOCKAGE
Medium Descr TRLUML BALO ANGIOP OPN ILIAC
Long Descr Transluminal balloon angioplasty, open; iliac
Status Code Active Code
Global Days 000 - Endoscopic or Minor Procedure
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 1 - 150% payment adjustment for bilateral procedures applies.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 2 - Payment restriction for assistants at surgery does not apply to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Inpatient Procedures, not paid under OPPS
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) none
MUE Not applicable/unspecified.
CCS Clinical Classification 60 - Embolectomy and endarterectomy of lower limbs
Date
Action
Notes
2011-01-01 Deleted Code deleted, see 37220, 37221, 37222, 37223, 37224, 37225, 37226, 37227.
Pre-1990 Added Code added.
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