Peripheral Angiogram CPT Code, Procedure, Anatomy, Radiology, and Stent Placement

Peripheral Angiogram:

• What is Peripheral Angiogram?
• CPT Code
• Procedure
• Anatomy
• Radiology
• Stent Placement

What is Peripheral Angiogram?

A Peripheral Angiogram is a diagnostic imaging procedure used to visualize the blood vessels outside the heart and brain — particularly in the arms, legs, and abdomen. The test helps identify blockages, narrowing (stenosis), or other vascular abnormalities that can restrict blood flow to the limbs. It is commonly performed in patients with symptoms of Peripheral Artery Disease (PAD), such as leg pain during walking, non-healing ulcers, or tissue ischemia.

The procedure involves injecting a contrast dye into the arteries through a thin catheter, followed by X-ray imaging to outline the vessel structure. Peripheral angiograms are essential in guiding treatment decisions, including angioplasty, stent placement, or surgical bypass. They provide detailed information about vessel patency, plaque buildup, and the extent of arterial disease.

CPT Code

The CPT codes for peripheral angiography vary depending on the anatomical site and whether interventions such as stent placement or angioplasty are performed. Common codes include:

• 75710 – Angiography, extremity, unilateral, radiological supervision and interpretation
• 75716 – Angiography, extremity, bilateral
• 75625 – Abdominal aortogram, including imaging of visceral arteries
• 37220–37235 – Codes for percutaneous transluminal revascularization, including angioplasty and stent placement (used depending on vessel treated)

Each code represents a specific part of the diagnostic or interventional process. If stent placement or angioplasty is performed, those procedures are coded separately under interventional radiology guidelines. Accurate coding is essential for proper billing and compliance with medical documentation standards.

Procedure

A Peripheral Angiogram procedure is typically performed under local anesthesia and conscious sedation in a catheterization lab or interventional radiology suite. The physician gains vascular access, usually through the femoral or radial artery, and advances a thin catheter to the target vessel. Once positioned, an iodine-based contrast dye is injected, and fluoroscopy (real-time X-ray imaging) is used to visualize the blood flow through the arteries.

The entire procedure takes about 30–60 minutes. After imaging, the physician reviews the angiograms to assess areas of narrowing or occlusion. If a significant blockage is found, treatment such as balloon angioplasty or stent placement can often be performed during the same session. Following the procedure, pressure is applied to the access site to prevent bleeding, and the patient is monitored for a few hours before discharge.

Anatomy

The anatomy visualized during a peripheral angiogram includes the arteries of the upper and lower limbs, the aorta, iliac arteries, renal arteries, and sometimes the visceral branches. For lower limb angiography, imaging typically extends from the abdominal aorta to the femoral, popliteal, and tibial arteries. In upper limb studies, the subclavian, axillary, brachial, and radial arteries are commonly evaluated.

Understanding vascular anatomy is critical for accurate interpretation and intervention. Variations in branching patterns, collateral circulation, and areas of calcification can affect treatment strategy. The angiogram provides a roadmap for targeted revascularization procedures and helps identify regions requiring stenting or surgical bypass.

Radiology

Radiology plays a central role in peripheral angiography, both diagnostically and therapeutically. The procedure uses fluoroscopy to capture high-resolution images of blood flow and vessel integrity. Modern angiography systems allow for 3D reconstruction, providing precise spatial orientation of arterial lesions. Digital subtraction angiography (DSA) further enhances image clarity by removing background bone and tissue structures from the image.

Radiologists and interventional specialists interpret these images to determine the presence and severity of disease. Radiologic reporting includes details such as the degree of stenosis, flow direction, collateral circulation, and presence of thrombus or embolic material. In cases requiring treatment, radiology-guided interventions—like angioplasty or stenting—can be performed immediately under the same imaging guidance.

Stent Placement

Stent placement is often performed during a peripheral angiogram if a significant arterial blockage is detected. A balloon catheter is used to dilate the narrowed area (angioplasty), followed by deployment of a stent—a small metal mesh tube—that helps keep the artery open. This restores adequate blood flow to the affected limb and relieves symptoms such as pain, cramping, or non-healing wounds.

Stents can be self-expanding or balloon-expandable, and are typically made of materials such as nitinol or stainless steel. The choice of stent depends on the vessel’s size, location, and the nature of the lesion. After stent placement, patients are usually prescribed antiplatelet medications to prevent clot formation. Follow-up imaging may be scheduled to monitor stent patency and ensure long-term success of the intervention.