A Friendly Guide to 2025 CPT Codes for Arterial Catheterization and Angiography

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A Friendly Guide to 2025 CPT Codes for Arterial Catheterization and Angiography

Hello, everyone. Let’s dive into the world of catheters, angiograms, and vascular families with a guide that’s as human as it gets—no robotic jargon here, just a chatty rundown to make your coding life easier.

What’s Arterial Catheterization All About?

In interventional radiology, arterial catheterization is like sending a tiny explorer into the body’s blood vessels to diagnose or treat issues. Think angiography (taking X-ray pictures of vessels), angioplasty (opening blocked arteries), or stent placement (propping vessels open). The arterial system is one of four vascular systems—alongside venous, pulmonary, and portal—and it’s where we’re focusing today. Procedures are split into two types: non-selective and selective catheter placements. Let’s break them down.

Non-Selective Catheter Placement: The Basics

Non-selective placement is when the catheter stays in the vessel it entered or only moves to the aorta. It’s like parking in the main lot without venturing further. Here are the 2025 CPT codes for non-selective arterial catheterization:

  • 36100: Needle or catheter into carotid or vertebral artery.
  • 36120: Retrograde brachial artery access.
  • 36140: Extremity artery access (arm or leg).
  • 36160: Aortic access via translumbar approach.
  • 36200: Catheter placement in the aorta.

Selective Catheter Placement: Going Deeper

Selective placement is when the catheter ventures beyond the aorta into a branch vessel, like exploring side streets. These codes follow a hierarchy based on vascular families (e.g., brachiocephalic, left carotid, left subclavian) and the order of branches—first, second, or third. Higher-order codes include all lower-order and non-selective placements along the path. Codes are split by location: above or below the diaphragm.

Above the Diaphragm

  • 36215: First-order thoracic or brachiocephalic branch.
  • 36216: Initial second-order thoracic or brachiocephalic branch.
  • 36217: Initial third-order or more selective thoracic or brachiocephalic branch.
  • +36218: Add-on for additional second-order, third-order, or beyond in the same vascular family.

Below the Diaphragm

  • 36245: First-order abdominal, pelvic, or lower extremity artery branch.
  • 36246: Initial second-order abdominal, pelvic, or lower extremity branch.
  • 36247: Initial third-order or more selective abdominal, pelvic, or lower extremity branch.
  • +36248: Add-on for additional second-order, third-order, or beyond in the same vascular family.

Angiography Codes: Capturing the Images

Angiography often goes hand-in-hand with catheterization to visualize vessels. Here’s a rundown of key 2025 CPT codes for arterial angiograms:

  • 75600: Descending thoracic aortogram (single shot).
  • 75605: Descending thoracic aortogram (multiple images).
  • 75625: Abdominal aortogram.
  • 75630: Abdominal aortogram with bilateral iliofemoral runoff.
  • 75658: Retrograde brachial angiogram.
  • 75705: Spinal selective (intercostal, lumbar).
  • 75710: Unilateral extremity (upper or lower).
  • 75716: Bilateral extremity (upper or lower).
  • 75726: Visceral selective (with or without aorta, abdominal or thoracic).
  • 75731: Adrenal, unilateral selective.
  • 75733: Adrenal, bilateral selective.
  • 75736: Pelvic selective.
  • 75741: Pulmonary, unilateral selective.
  • 75743: Pulmonary, bilateral selective.
  • 75746: Pulmonary, non-selective.
  • 75756: Internal mammary.
  • +75774: Add-on for each additional vessel after basic selective.

Why Coding Right Matters

Getting these codes right is like nailing the perfect recipe—it ensures smooth billing and keeps auditors at bay. Always check procedure notes to confirm the catheter’s path and vascular family. For selective placements, remember that higher-order codes include all prior steps, so don’t double-code non-selective placements. 

Whether you’re coding for a quick aortic catheterization or a complex selective angiogram, the 2025 CPT codes (36100–36248, 75600–75774) have you covered. Keep this guide handy, cross-reference with procedure notes, and check the AMA’s latest updates if you’re unsure. Got a coding conundrum? Drop a comment below, and let’s sort it out together!

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