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Official Description

Transcatheter placement of intravascular stent(s), cervical carotid artery, open or percutaneous, including angioplasty, when performed, and radiological supervision and interpretation; with distal embolic protection

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 37215 refers to the transcatheter placement of intravascular stent(s) specifically in the cervical carotid artery. This procedure can be performed using either an open or percutaneous approach, which involves the insertion of a stent to treat stenosis, or narrowing, of the artery. The procedure includes angioplasty, if performed, and requires radiological supervision and interpretation. A key aspect of this procedure is the use of a distal embolic protection device, which is designed to prevent debris from traveling downstream during the stenting process. This is particularly important in the cervical carotid artery, where the risk of embolization can lead to serious complications, such as stroke. The procedure is typically indicated for patients with significant arterial blockage due to conditions like arteriosclerosis, and it aims to restore normal blood flow while minimizing the risk of embolic events. The detailed steps involved in the procedure ensure that it is performed safely and effectively, with careful consideration of the patient's anatomy and the specific characteristics of the stenosis being treated.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The transcatheter placement of intravascular stent(s) in the cervical carotid artery is indicated for patients presenting with significant stenosis due to various conditions. The following are the explicitly provided indications for this procedure:

  • Severe Arteriosclerotic Disease - This condition leads to the narrowing of the cervical carotid artery, necessitating intervention to restore adequate blood flow.
  • Stenosis of the Cervical Carotid Artery - The procedure is specifically indicated for patients with a significant degree of narrowing in this artery, which can increase the risk of stroke.

2. Procedure

The procedure for the transcatheter placement of intravascular stent(s) in the cervical carotid artery involves several detailed steps, which are as follows:

  • Percutaneous Approach - For a percutaneous approach, the procedure begins with the puncture of the femoral or another artery, followed by the insertion of an introducer sheath. A guidewire is then introduced and advanced into the aortic arch. A carotid configuration catheter is subsequently advanced over the guidewire into the aortic arch. Roadmapping angiograms are obtained of the common carotid artery to visualize the anatomy. After removing the guidewire, a hydrophilic wire is introduced, and the carotid configuration catheter is inserted over this wire, conforming to the patient's anatomy as it is advanced into the common carotid artery.
  • Open Approach - In cases where the open approach is preferred, the introducer sheath is inserted through a surgically exposed common carotid artery via a small skin incision. This approach is typically utilized in patients with severe arteriosclerotic disease affecting the femoral or iliac arteries, or the aorta. Similar to the percutaneous method, roadmapping angiography is performed on the cervical carotid artery, and measurements of the artery and area of stenosis are taken. The hydrophilic wire is then advanced into the external carotid artery, and the carotid catheter is advanced over this wire. The hydrophilic wire is removed, and a stiff wire is advanced to the site of the stenosis.
  • Guiding Sheath Placement - A long guiding sheath is advanced over the carotid catheter and stiff wire. After removing the carotid catheter and stiff wire, the long guiding sheath remains in place to facilitate the subsequent steps of the procedure.
  • Embolic Protection Device Deployment - In CPT® Code 37215, a distal embolic protection device is utilized. The deployment device is advanced across the lesion and positioned in the extracranial aspect of the internal carotid artery. The umbrella filter is then opened, and the embolic protection deployment device is removed to ensure that any debris is captured during the procedure.
  • Angioplasty and Stent Placement - Angioplasty may be performed prior to stent placement. A balloon catheter is advanced to the site of the lesion and inflated to dilate the area of stenosis. After the balloon catheter is removed, the stent delivery catheter is advanced to the lesion site and carefully positioned. The stent is deployed, and the delivery catheter is subsequently removed. A balloon catheter may again be advanced and inflated to ensure proper seating of the stent.
  • Completion of the Procedure - Finally, all catheters are removed, and pressure is applied to the venous access site to control any bleeding and ensure hemostasis.

3. Post-Procedure

Post-procedure care following the transcatheter placement of intravascular stent(s) in the cervical carotid artery involves monitoring the patient for any complications, such as bleeding or neurological deficits. Patients may be advised to rest and avoid strenuous activities for a specified period. Follow-up imaging may be required to assess the patency of the stent and the condition of the cervical carotid artery. Additionally, patients may be placed on antiplatelet therapy to reduce the risk of thromboembolic events following the procedure. It is essential for healthcare providers to provide clear instructions regarding medication adherence and lifestyle modifications to support recovery and prevent future cardiovascular events.

Short Descr TRANSCATH STENT CCA W/EPS
Medium Descr TCAT IV STENT CRV CRTD ART EMBOLIC PROTECJ
Long Descr Transcatheter placement of intravascular stent(s), cervical carotid artery, open or percutaneous, including angioplasty, when performed, and radiological supervision and interpretation; with distal embolic protection
Status Code Restricted Coverage
Global Days 090 - Major Surgery
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) 0 - 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 Inpatient Procedures, not paid under OPPS
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P1G - Major procedure - Other
MUE 1
CCS Clinical Classification 59 - Other OR procedures on vessels of head and neck

This is a primary code that can be used with these additional add-on codes.

37252 Addon Code MPFS Status: Active Code APC N ASC N1 Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; initial noncoronary vessel (List separately in addition to code for primary procedure)
37253 Addon Code MPFS Status: Active Code APC N ASC N1 Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; each additional noncoronary vessel (List separately in addition to code for primary procedure)
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
Q0 Investigational clinical service provided in a clinical research study that is in an approved clinical research study
GC This service has been performed in part by a resident under the direction of a teaching physician
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
X5 Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
50 Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d).
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
62 Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate.
77 Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
81 Minimum assistant surgeon: minimum surgical assistant services are identified by adding modifier 81 to the usual procedure number.
AG Primary physician
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
CG Policy criteria applied
CR Catastrophe/disaster related
ET Emergency services
GA Waiver of liability statement issued as required by payer policy, individual case
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GW Service not related to the hospice patient's terminal condition
GX Notice of liability issued, voluntary under payer policy
GZ Item or service expected to be denied as not reasonable and necessary
KX Requirements specified in the medical policy have been met
PD Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
RC Right coronary artery
X4 Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
2017-01-01 Changed Moderate (Conscious) Sedation flag removed. See new Moderate Sedation category.
2015-01-01 Changed Description Changed
2013-01-01 Changed Guideline information changed.
2011-01-01 Changed Short description changed.
2005-01-01 Added First appearance in code book in 2005.
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