Interventional Radiology CPT codes are Current Procedural Terminology (CPT) codes that providers use to report or bill insurance companies for minimally invasive procedures performed under image guidance. These procedures commonly use fluoroscopy, ultrasound, CT, or MRI to diagnose or treat diseases without requiring major surgery. The use of correct IR CPT codes is essential because it can affect the financial health of any practice performing interventional radiology services.
Understanding IR CPT codes can be challenging. Many procedures involve multiple components, imaging guidance, selective catheterization, and bundled services that require careful code selection.
This guide explains the most commonly used interventional radiology CPT codes.
These CPT codes help healthcare providers accurately document procedures and ensure getting full reimbursement from Medicare, Medicaid, and commercial insurance payers.
Vascular Intervention CPT Codes
As a biller, you can use vascular intervention CPT codes for minimally invasive procedures that treat narrowed or blocked arteries and veins. These procedures commonly include angioplasty, stent placement, atherectomy, and other endovascular treatments performed under fluoroscopic guidance.
| CPT Code | Procedure |
|---|---|
| 37220 | Iliac artery angioplasty |
| 37221 | Iliac artery angioplasty with stent |
| 37222 | Additional iliac intervention |
| 37224 | Femoral/popliteal angioplasty |
| 37225 | Atherectomy, femoral/popliteal |
| 37226 | Stent placement |
| 37227 | Atherectomy with stent |
| 37228 | Tibial/peroneal angioplasty |
| 37229 | Tibial atherectomy |
| 37230 | Tibial stent placement |
| 37231 | Tibial atherectomy with stent |
| 37232 | Additional tibial vessel intervention |
| 37233 | Additional tibial atherectomy |
| 37234 | Additional tibial stent |
| 37235 | Additional tibial atherectomy with stent |
Note: These lower-extremity revascularization codes have undergone significant revisions for 2026. The updated code set is discussed later in this guide.
Diagnostic Angiography CPT Codes
Diagnostic angiography CPT codes report imaging studies performed to evaluate blood vessels before treatment or when diagnostic findings are medically necessary.
| CPT Code | Procedure |
|---|---|
| CPT 36221 | Thoracic aortography |
| 36222 | Thoracic aortic branch angiography |
| 36223 | Cervicocerebral angiography |
| 36224 | Internal carotid angiography |
| 36225 | External carotid angiography |
| 36226 | Vertebral angiography |
| 36227 | Additional cervicocerebral study |
| 36245 | Selective arterial catheterization |
| 36246 | Second-order arterial catheterization |
| 36247 | Third-order arterial catheterization |
| 36248 | Additional selective catheterization |
Embolization CPT Codes
Healthcare providers use Embolization CPT codes when blood vessels are intentionally blocked to stop bleeding, reduce blood f`low to tumors, or treat vascular abnormalities. These specific procedures are commonly performed for trauma, uterine fibroids, aneurysms, gastrointestinal bleeding, and certain cancers.
| CPT Code | Procedure |
|---|---|
| 37241 | Venous embolization |
| 37242 | Arterial embolization |
| 37243 | Tumor embolization |
| 37244 | Hemorrhage embolization |
Venous Access & Central Venous Catheter CPT Codes
Venous Access & Central Venous Catheter CPT Codes report the placement, replacement, and removal of central venous access devices.
| CPT Code | Procedure |
|---|---|
| 36555 | Non-tunneled central venous catheter (<5 years) |
| 36556 | Non-tunneled central venous catheter (5 years or older) |
| 36557 | Tunneled central venous catheter |
| 36558 | Tunneled catheter without port |
| 36560 | Tunneled catheter with subcutaneous port |
| 36561 | Implantable venous access port |
| 36563 | Removal and replacement of catheter |
| 36569 | PICC insertion |
| 36571 | PICC replacement |
Dialysis Access CPT Codes
Dialysis access CPT codes are used to report procedures that create, maintain, or restore vascular access for hemodialysis. These procedures help keep arteriovenous (AV) fistulas and grafts working properly, ensuring reliable dialysis treatment for patients with kidney failure.
| CPT Code | Procedure |
|---|---|
| 36901 | Dialysis circuit evaluation |
| 36902 | Angioplasty of dialysis access |
| 36903 | Angioplasty with thrombectomy |
| 36904 | Drug-coated balloon intervention |
| 36905 | Stent placement |
| 36906 | Mechanical thrombectomy with stent |
| 36907 | Additional venous angioplasty |
| 36908 | Additional stent placement |
| 36909 | Dialysis embolization |
Image-Guided Biopsy CPT Codes
Image-guided biopsy procedures allow physicians to collect tissue samples using ultrasound, CT, MRI, or fluoroscopic guidance.
| CPT Code | Procedure |
|---|---|
| 49180 | Abdominal biopsy |
| 47000 | Liver biopsy |
| 50200 | Kidney biopsy |
| 32408 | Lung biopsy with imaging guidance |
| 38505 | Lymph node biopsy |
| 10005 | Fine needle aspiration with ultrasound |
| 10009 | Fine needle aspiration, additional lesion |
Drainage & Aspiration CPT Codes
Drainage and aspiration procedures remove abnormal collections of fluid, pus, blood, or air using image guidance.
| CPT Code | Procedure |
|---|---|
| 49405 | Abscess drainage |
| 49406 | Additional drainage procedure |
| 32555 | Thoracentesis |
| 32556 | Chest tube insertion |
| 50390 | Percutaneous nephrostomy exchange |
| 10160 | Aspiration of cyst or hematoma |
Tumor Ablation CPT Codes
Tumor ablation CPT codes report minimally invasive procedures that destroy tumors using heat, cold, microwave energy, or radiofrequency energy. These treatments are commonly used for liver, kidney, lung, bone, and soft tissue tumors when surgery is not the preferred option.
| CPT Code | Used for Procedure |
|---|---|
| 47382 | Radiofrequency ablation of liver tumor |
| 47383 | Cryoablation of liver tumor |
| 50592 | Renal tumor ablation |
| 32994 | Lung tumor ablation |
| 20983 | Bone tumor ablation |
Thrombectomy & Thrombolysis CPT Codes
Medical billers use thrombectomy and thrombolysis CPT codes for procedures that restore blood flow by removing or dissolving blood clots in arteries, veins, or dialysis access circuits.
| CPT Code | Procedure |
|---|---|
| 37184 | Primary percutaneous arterial mechanical thrombectomy |
| 37185 | Additional arterial thrombectomy session |
| 37186 | Repeat arterial thrombectomy |
| 37187 | Venous mechanical thrombectomy |
| 37188 | Pharmacomechanical venous thrombectomy |
| 37191 | Retrieval of IVC filter |
| 36903 | Dialysis circuit thrombectomy with angioplasty |
| 36906 | Dialysis thrombectomy with stent placement |
Inferior Vena Cava (IVC) Filter CPT Codes
IVC filter procedures involve placing or removing a filter in the inferior vena cava to prevent blood clots from reaching the lungs.
| CPT Code | Procedure |
|---|---|
| 37191 | IVC filter retrieval |
| 37192 | IVC filter placement |
Biliary Intervention CPT Codes
Biliary intervention CPT codes report image-guided procedures performed on the bile ducts to relieve obstruction, treat strictures, remove stones, or provide drainage.
| CPT Code | Procedure |
|---|---|
| 47531 | Percutaneous biliary drainage |
| 47532 | Internal/external biliary drainage catheter |
| 47533 | Biliary catheter exchange |
| 47534 | Placement of biliary stent |
| 47535 | Biliary catheter removal |
Gastrointestinal (GI) Intervention CPT Codes
Gastrointestinal interventional radiology procedures provide minimally invasive treatment for feeding access, abscess drainage, gastrointestinal bleeding, and other digestive tract conditions. Many of these procedures are performed using fluoroscopic guidance.
| CPT Code | Procedure |
|---|---|
| 49440 | Percutaneous gastrostomy tube placement |
| 49441 | Gastrostomy tube replacement |
| 49442 | Gastrojejunostomy tube placement |
| 49446 | Conversion of gastrostomy to gastrojejunostomy |
| 49450 | Replacement of gastrostomy tube |
| 49451 | Replacement of gastrojejunostomy tube |
Genitourinary (GU) Intervention CPT Codes
Genitourinary IR procedures focus on the kidneys, ureters, bladder, and urinary drainage system. These procedures are commonly performed to relieve urinary obstruction, treat stones, or maintain nephrostomy access.
| CPT Code | Procedure |
|---|---|
| 50432 | Percutaneous nephrostomy placement |
| 50435 | Nephrostomy catheter exchange |
| 50436 | Nephroureteral catheter placement |
| 50387 | Removal of nephroureteral catheter |
| 50389 | Removal of nephrostomy catheter |
Neurointerventional Radiology CPT Codes
Neurointerventional procedures use catheter-based techniques to diagnose and treat disorders affecting the brain, neck, and spinal blood vessels. They are commonly performed for stroke, aneurysms, arteriovenous malformations (AVMs), and carotid artery disease.
| CPT Code | Procedure |
|---|---|
| 61624 | Transcatheter embolization of CNS lesion |
| 61626 | Intracranial balloon occlusion |
| 61635 | Intracranial stent placement |
| 61640 | Endovascular treatment of aneurysm |
| 75894 | Follow-up angiography after embolization |
| 75898 | Angiography after embolization completion |
Spine & Pain Management CPT Codes
Interventional radiologists also perform several minimally invasive spine procedures to diagnose and manage pain, fractures, and spinal tumors. Many of these procedures are guided by fluoroscopy or CT imaging.
| CPT Code | Procedure |
|---|---|
| 22513 | Percutaneous vertebral augmentation (thoracic) |
| 22514 | Vertebral augmentation (lumbar) |
| 22515 | Additional vertebral level |
| 62267 | Percutaneous aspiration of spinal cyst |
| 64483 | Lumbar transforaminal epidural injection |
| 64484 | Additional lumbar level injection |
Portal Venous & TIPS Procedure CPT Codes
Portal venous interventions help manage complications of portal hypertension, liver cirrhosis, and portal vein obstruction. One of the most common procedures is the Transjugular Intrahepatic Portosystemic Shunt (TIPS), which reduces portal pressure and controls complications such as variceal bleeding and refractory ascites.
| CPT Code | Procedure |
|---|---|
| 37182 | Initial TIPS creation |
| 37183 | TIPS revision |
| 37181 | Portal decompression procedure |
Common Image Guidance CPT Codes Used in Interventional Radiology
Many IR procedures include imaging guidance as part of the primary CPT code. However, some procedures may require separate reporting when allowed under CPT guidelines. Understanding when imaging is bundled versus separately reportable is essential for accurate coding.
| CPT Code | Procedure |
|---|---|
| 76937 | Ultrasound guidance for vascular access |
| 76942 | Ultrasound guidance for needle placement |
| 77001 | Fluoroscopic guidance for central venous access |
| 77012 | CT guidance for needle placement |
| 77013 | CT guidance for ablation |
| 77021 | MRI guidance for needle placement |
Before billing a separate imaging guidance code, verify whether it is already bundled into the primary procedure code. Many modern IR CPT codes include imaging guidance and do not allow separate billing.
Frequently Used Selective Catheterization CPT Codes
Selective catheterization is one of the most common components of interventional radiology procedures. The CPT code depends on the vascular family entered and the level of catheter advancement.
| CPT Code | Procedure |
|---|---|
| 36245 | First-order selective catheterization |
| 36246 | Second-order selective catheterization |
| 36247 | Third-order or greater catheterization |
| 36248 | Additional second- or third-order branch |
Common Venography CPT Codes
Venography evaluates the veins using contrast material and fluoroscopic imaging. It is commonly performed before venous interventions, thrombectomy procedures, or evaluation of venous obstruction.
| CPT Code | Procedure |
|---|---|
| 75820 | Unilateral extremity venography |
| 75822 | Bilateral extremity venography |
| 75825 | Inferior vena cavography |
Common Arteriography CPT Codes
Arteriography provides detailed imaging of arteries to diagnose stenosis, aneurysms, occlusions, and vascular malformations before or during interventional treatment.
| CPT Code | Procedure |
|---|---|
| 75625 | Abdominal aortography |
| 75630 | Aortoiliac angiography |
| 75710 | Unilateral extremity angiography |
| 75716 | Bilateral extremity angiography |
What Changed for Interventional Radiology CPT Codes in 2026
The CY 2026 CPT code set and the CMS Medicare Physician Fee Schedule (MPFS) final rule, released October 31, 2025, and effective January 1, 2026, brought the most significant changes to interventional radiology coding and the payment system. Here is what actually changed:
Changes in CPT Codes in 2026
Several important CPT code updates took effect in 2026 for interventional radiology.
- Lower extremity revascularization CPT codes changed the most. CPT codes 37220–37235 were deleted and replaced with 46 new codes (37254–37299). The new codes are organized by vascular territory, lesion complexity, and the type of procedure performed.
- CPT code 75577 was introduced for coronary plaque assessment using advanced software analysis. It replaces the former Category III codes 0623T–0626T.
- The TEVAR CPT codes (33880, 33881, 33883, and 33886) were revised. The code descriptions were updated to better match current thoracic endovascular aortic repair (TEVAR) procedures.
Interventional Radiology CPT Codes Payment Changes in 2026
CMS made several payment updates for interventional radiology procedures in 2026.
- CMS applied a 2.5% efficiency adjustment to most non-time-based CPT codes. This change affects many commonly performed IR procedures, including venous access and peripheral angioplasty.
- For procedures performed in hospital settings, Medicare reduced indirect practice expense payments. As a result, many facility-based IR procedures may see about a 10% reduction in total RVUs.
- Bone marrow biopsy CPT codes (38220 and 38222) received some of the largest payment reductions, with RVUs decreasing by approximately 15%–17%.
- Medicare raised reimbursement rate for certain drug-coated balloons, drug-eluting tibial stents, and angiography supply packs, providing higher payments for some lower extremity revascularization procedures.
- New Category I CPT codes introduced in 2026 are not subject to the 2.5% efficiency adjustment, giving them more favorable reimbursement.
- CMS also slightly increased the Medicare conversion factor for 2026, resulting in a modest overall payment increase for physicians. However, the actual financial impact depends on the types of procedures a practice performs.
IR CPT Codes Rule and Reporting Changes in 2026
Several reporting and compliance updates also took effect in 2026.
- CMS introduced the Interventional Radiology Merit-based Incentive Payment System (MIPS) Value Pathway (MVP) as a voluntary reporting option starting with the 2026 performance year.
- Seven new quality measures were added to the IR-specific MIPS measure set, giving providers more reporting options.
- CMS permanently allows real-time audio-video supervision for certain “incident-to” services, replacing the previous requirement for in-person supervision in eligible situations.
- The new lower extremity revascularization (LER) CPT codes require more detailed documentation than the previous codes. During the transition to the new code set, insurance payers may review these claims more carefully. Clear documentation and accurate accurate CPT and ICD-10 coding can help reduce claim denials and payment delays.
Conclusion
Interventional radiology CPT codes cover a wide range of minimally invasive procedures, from vascular interventions and embolization to biopsies, drainage procedures, tumor ablation, and dialysis access. Using the correct CPT code is important for accurate documentation, proper reimbursement, reducing claim denials, and boosting the financial health of healthcare practices.
The 2026 CPT updates introduced several important changes, including a new code family for lower extremity revascularization and other coding and payment updates. Staying up to date with these changes and following the latest CPT guidelines can help healthcare providers, coders, and billers submit accurate claims and improve the overall billing process.
Frequently Asked Questions
Questions? We’ve got you covered
What is the CPT code for an angiogram?
There is no single CPT code for an angiogram. The correct code depends on which blood vessel is examined and how the procedure is performed.
In many cases, an angiogram is reported using a catheter placement code (such as 36245–36248) along with the appropriate imaging code. However, some interventional radiology procedures already include angiography in the primary CPT code, so a separate angiogram code cannot be billed. Always check the latest CPT coding guidelines before reporting the procedure.
What is the difference between CPT codes 36245, 36246, and 36247?
These codes describe increasing “orders” of selective catheterization within the abdominal, pelvic, or lower extremity arterial system.
36245 is the first vessel selectively catheterized off the aorta, 36246 is a second-order branch off that first vessel, and 36247 covers third-order or more distant branches.
What is the CPT code for a peripheral angioplasty?
The CPT code for a peripheral angioplasty depends on the blood vessel being treated.
For lower extremity arteries, angioplasty is reported using the new 37254–37299 CPT code family introduced in 2026. For renal, visceral, upper extremity, or venous angioplasty, CPT codes 37246–37249 are still used. The correct code depends on the treatment area and whether it is the initial or an additional vessel.
What is the CPT code for a port placement or central venous catheter?
The CPT code depends on the type of central venous catheter being placed.
For example, 36561 is commonly used for a tunneled central venous catheter with a subcutaneous port, while 36557–36558 are used for tunneled catheters without a port, and 36555–36556 are used for non-tunneled central venous catheters. In some cases, ultrasound (76937) or fluoroscopy (77001) guidance may also be reported separately if allowed by CPT guidelines and properly documented.
What is the CPT code for mechanical thrombectomy?
Primary mechanical thrombectomy uses 37184 for the initial vessel treated and 37185 as an add-on for additional vessels in the same vascular family. Secondary mechanical thrombectomy — performed as part of another primary procedure rather than as the definitive treatment — is reported with 37186. Venous mechanical thrombectomy has its own codes, 37187 for the initial treatment and 37188 for a repeat treatment.
What is the CPT code for IVC filter placement and removal?
Placement of an inferior vena cava filter via an endovascular approach is coded 37191. Repositioning an existing filter is 37192, and retrieval or removal of the filter is 37193.
How has the 2026 Medicare Physician Fee Schedule affected interventional radiology payment specifically?
Two structural changes matter most: a recurring 2.5% “efficiency adjustment” applied to work RVUs for most non-time-based codes, and a 50% reduction in the facility-setting portion of indirect practice expense allocated by work RVU, which together are producing meaningful reimbursement reductions — in some cases around 10% — for interventional procedures performed in hospital settings, even as the overall Medicare conversion factor rose modestly for 2026.
Do I need a modifier to bill a diagnostic angiogram on the same day as an intervention?
It depends. If a diagnostic angiogram is performed before an intervention and provides new information that affects the treatment plan, it may be billed separately. In many cases, payers require an appropriate modifier, such as -59 or an applicable X{EPSU} modifier, along with clear documentation showing that the diagnostic study was separate from the intervention. Without proper documentation, the diagnostic angiogram is usually considered part of the intervention and may not be reimbursed separately.
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