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Code deleted, see 37228, 37229, 37230, 37231, 37232, 37233, 37234, 37235.

Official Description

Transluminal balloon angioplasty, percutaneous; tibioperoneal trunk or branches, each vessel

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 35470 refers to transluminal balloon angioplasty performed percutaneously on the tibioperoneal trunk or its branches, specifically addressing each vessel treated. This minimally invasive technique is utilized to restore blood flow in cases where there is an occlusion or narrowing of the arteries in the lower leg, particularly affecting the tibioperoneal trunk or its branches. The process begins with the preparation of the skin over the access artery, typically one of the femoral arteries, followed by puncturing the artery with a needle to insert a sheath. A guidewire is then navigated through the access artery into the occluded area. A catheter equipped with a balloon tip is advanced over this guidewire to the site of the blockage. Once positioned, the balloon is inflated, which compresses the plaque against the arterial wall, thereby widening the vessel. This inflation may be repeated multiple times to achieve optimal results. After the angioplasty, the catheter is exchanged for a guidewire, and an angiography catheter is introduced to assess the success of the procedure through completion angiography, ensuring that the artery remains patent. Finally, the angiography catheter is removed, and pressure is applied to the puncture site to manage any bleeding, followed by the application of a pressure dressing. This procedure is coded as 35470 for each vessel treated, highlighting its specificity in addressing vascular occlusions in the lower extremities.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The indications for performing transluminal balloon angioplasty as described by CPT® Code 35470 include the following conditions affecting the tibioperoneal trunk or its branches:

  • Occlusion of the Tibioperoneal Trunk - This condition involves a blockage in the main artery that supplies blood to the lower leg, which can lead to reduced blood flow and associated symptoms.
  • Narrowing of the Arteries - A significant narrowing, or stenosis, in the tibioperoneal trunk or its branches can impede blood flow, necessitating intervention to restore adequate circulation.
  • Peripheral Artery Disease (PAD) - Patients with PAD may experience symptoms such as claudication, pain, or discomfort in the legs due to insufficient blood flow, making angioplasty a viable treatment option.

2. Procedure

The procedure for transluminal balloon angioplasty involves several critical steps, each designed to ensure effective treatment of the occluded vessel:

  • Step 1: Preparation and Access - The skin over the access artery, typically one of the femoral arteries, is thoroughly prepped to maintain a sterile environment. A needle is then used to puncture the artery, and a sheath is placed to facilitate the introduction of other instruments.
  • Step 2: Guidewire Insertion - A guidewire is inserted through the sheath and advanced from the access artery into the occluded tibioperoneal trunk or branch. This guidewire serves as a pathway for subsequent devices.
  • Step 3: Catheter Advancement - A catheter with a balloon tip is carefully advanced over the guidewire to the site of the occlusion. This step is crucial for positioning the balloon at the precise location of the blockage.
  • Step 4: Balloon Inflation - Once the catheter is in place, the balloon is inflated. This inflation compresses the plaque against the arterial wall, widening the vessel and restoring blood flow. The balloon may be inflated multiple times to achieve the desired level of dilation.
  • Step 5: Guidewire Exchange - After the angioplasty is completed, the angioplasty catheter is exchanged for a guidewire, which remains in place to facilitate further assessment.
  • Step 6: Completion Angiography - An angiography catheter is advanced over the guidewire, and the guidewire is withdrawn. Contrast material is injected to visualize the artery, and completion angiography is performed to confirm that the artery is patent and that blood flow has been restored.
  • Step 7: Post-Procedure Care - After the completion angiography, the angiography catheter is withdrawn. Pressure is applied to the arterial puncture site to control any bleeding, and a pressure dressing is applied to ensure proper healing.

3. Post-Procedure

Post-procedure care following transluminal balloon angioplasty includes monitoring the puncture site for bleeding and ensuring that the patient is stable. Patients may be advised to rest and avoid strenuous activities for a specified period to promote healing. Follow-up appointments may be scheduled to assess the success of the procedure and monitor for any potential complications. It is essential to provide patients with instructions regarding signs of infection or other issues that may arise at the puncture site, ensuring they understand when to seek further medical attention.

Short Descr REPAIR ARTERIAL BLOCKAGE
Medium Descr TRLUML BALO ANGIOP PRQ TIBPRNL TRNK/BRNCH EA
Long Descr Transluminal balloon angioplasty, percutaneous; tibioperoneal trunk or branches, each vessel
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) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Significant Procedure, Multiple Reduction Applies
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 37228, 37229, 37230, 37231, 37232, 37233, 37234, 37235.
1992-01-01 Added Code added.
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