Peripheral Atherectomy and Thrombectomy Devices

Atherectomy and endovascular revascularization (CPT 37220–37247) are covered for symptomatic peripheral vascular disease (limb‑threatening ischemia or functionally limiting claudication) only when eviCore selection criteria are met—typically hemodynamically significant stenosis (generally >70%), lesions that are eccentric or do not dilate with or are contraindicated for balloon angioplasty, or vein bypass graft stenosis. Mechanical/laser atherectomy of renal/visceral arteries, abdominal aorta/brachiocephalic trunk and branches, isolated Trellis pharmacomechanical thrombolysis for DVT/Paget‑Schroetter, drug‑eluting balloons in vein grafts/dialysis accesses/other peripheral arteries, and intravascular shockwave lithotripsy for multiple named peripheral and renal/celiac lesions are considered experimental/investigational and excluded.

"ICD-10 code I74."

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