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

Official Description

Transluminal balloon angioplasty, open; femoral-popliteal

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 35456 refers to a transluminal balloon angioplasty performed on the femoral-popliteal artery. This is a minimally invasive surgical technique used to treat blockages or narrowing in the artery that can impede blood flow to the lower extremities. The term "transluminal" indicates that the procedure is performed within the lumen of the artery, utilizing a balloon catheter to dilate the narrowed area. The femoral-popliteal artery is a critical vessel that supplies blood to the thigh and lower leg, and blockages here can lead to significant complications, including pain, ulcers, or even limb loss. During the procedure, the physician makes an incision to access the artery, allowing for direct intervention. A guidewire is then navigated through the artery to the site of the blockage, where a balloon catheter is positioned. Once in place, the balloon is inflated to compress the plaque against the arterial wall, thereby widening the artery and restoring blood flow. This inflation may be repeated multiple times to achieve optimal results. Following the angioplasty, a completion angiography is performed to confirm the success of the procedure and ensure that the artery remains open. The access site is then repaired, and the skin incision is closed, marking the end of the procedure. This technique is essential for improving circulation and alleviating symptoms associated with arterial blockages in the lower extremities.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 35456 is indicated for patients experiencing conditions related to arterial blockages in the femoral-popliteal region. The following are specific indications for performing this procedure:

  • 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 inadequate blood flow.
  • Critical Limb Ischemia - A severe obstruction of blood flow to the extremities, which can lead to pain at rest, ulcers, or gangrene.
  • Rest Pain - Pain in the feet or toes while resting, indicating significant arterial blockage.

2. Procedure

The procedure for CPT® Code 35456 involves several critical steps to ensure successful angioplasty of the femoral-popliteal artery:

  • Step 1: Preparation and Access - The skin over the access artery is thoroughly prepped and incised to allow for direct access. This step is crucial for maintaining a sterile environment and minimizing the risk of infection.
  • Step 2: Artery Exposure - The physician carefully exposes the femoral-popliteal artery, ensuring that it is adequately visualized for the subsequent steps of the procedure.
  • Step 3: Sheath Placement - A small nick is made in the artery, and a sheath is placed within it. This sheath serves as a conduit for the guidewire and catheter, facilitating access to the arterial lumen.
  • Step 4: Guidewire Insertion - A guidewire is inserted through the sheath and advanced from the access site into the occluded femoral-popliteal artery. This guidewire is essential for navigating the catheter to the blockage.
  • Step 5: Balloon Catheter Advancement - A catheter with a balloon tip is advanced over the guidewire to the site of the occlusion. This step is critical for preparing to dilate the narrowed artery.
  • Step 6: Balloon Inflation - The balloon is inflated at the site of the blockage, compressing the plaque against the arterial wall. This inflation may be performed multiple times to achieve the desired arterial dilation.
  • Step 7: Guidewire Exchange - After the angioplasty, the angioplasty catheter is exchanged for a guidewire, allowing for the next phase of the procedure.
  • Step 8: Completion Angiography - An angiography catheter is advanced over the guidewire, and the guidewire is withdrawn. Contrast material is injected to visualize the artery, and a completion angiography is performed to confirm that the artery is patent and blood flow is restored.
  • Step 9: Closure - The angiography catheter is withdrawn, and the access artery is repaired. Finally, the skin incision is closed, completing the procedure.

3. Post-Procedure

After the completion of the angioplasty procedure, patients typically undergo monitoring to assess for any complications or adverse effects. Post-procedure care may include instructions for activity restrictions, pain management, and signs of potential complications such as bleeding or infection at the incision site. Patients are often advised to follow up with their healthcare provider to evaluate the success of the procedure and to discuss any further treatment options if necessary. Recovery time can vary based on individual patient factors and the extent of the procedure performed.

Short Descr REPAIR ARTERIAL BLOCKAGE
Medium Descr TRLUML BALO ANGIOP OPN FEM-POP
Long Descr Transluminal balloon angioplasty, open; femoral-popliteal
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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