Shockwave Peripheral IVL Reimbursement
Going deep into peripheral IVL reimbursement: Shockwave peripheral IVL has reimbursement in the outpatient, ambulatory surgical center (ASC) and inpatient setting.
Shockwave Peripheral IVL Physician Reimbursement
In calendar year 2026 (CY2026), The Centers for Medicare & Medicaid Services (CMS) established relative value units (RVUs) and associated payment for Current Procedural Terminology (CPT) +37262 and +37279, Category I Add-on codes for iliac and femoral-popliteal IVL, respectively.
These add-on codes were established as part of the overhaul of the lower extremity revascularization codes. There are 46 new codes for describing services performed for peripheral artery revascularization. Codes for these interventions are based on vascular territories and classified based on lesion types: straightforward for stenosis or complex for occlusion. IVL is reported through the use of the appropriate add-on code to the primary procedure code in the designated vascular territory.
| CPT | Description | Work RVUs | Physician Facility Payment |
| +37262 | Intravascular lithotripsy, iliac vascular territory | 3.0 | $136* |
| +37279 | Intravascular lithotripsy, femoral and popliteal vascular territory | 4.0 | $182* |
*Physician Facility Payment is based on Total Relative Value Units
Application & Impact of Shockwave Peripheral IVL CPT Codes +37262 and +37279
The tables below provide examples of how utilizing Peripheral IVL and reporting CPT codes +37262 or +37279 in conjunction with a primary procedure code impacts the total work RVUs and physician payment associated with a procedure.
CPT codes +37262 and +37279 are add-on codes and may be used with all primary CPT codes for Iliac and Femoral-Popliteal procedures. For a complete description of the appropriate use of the peripheral IVL add-on codes, please refer to the most current edition of the CPT codebook from AMA CPT Editorial Panel. The tables below describe the impact that +37262 and +37279 have on the primary peripheral procedure codes with which Peripheral IVL is most frequently utilized. The RVUs and payments associated with +37262 and +37279 are in addition to payments associated with the primary procedure.
Accordion Section
| Without Peripheral IVL | With Peripheral IVL2 | |||||
| CPT® | Description | Work RVUs3 | Plus | Work RVUs3 | Equals | Total Work RVUs |
| 37254 | PTA (Straightforward) |
7.30 |
+ |
3.0 |
= |
10.30 |
| 37258 | Stent (Straightforward) |
8.75 |
+ |
3.0 |
= |
11.75 |
| Without Peripheral IVL | With Peripheral IVL2 | |||||
| CPT® | Description | Work RVUs3 | Plus | Work RVUs3 | Equals | Total Work RVUs |
| 37263 | PTA (Straightforward) |
7.75 |
+ |
4.0 |
= |
11.75 |
| 37267 | Stent (Straightforward) |
8.75 |
+ |
4.0 |
= |
12.75 |
| 37271 | Atherectomy (Straightforward) | 9.00 |
+ |
4.0 |
= |
13.00 |
| 37275 | Stent + Atherectomy (Straightforward) | 11.00 |
+ |
4.0 |
= |
15.00 |
| Without Peripheral IVL | With Peripheral IVL2 | |||||
| CPT® | Description | Work RVUs3 | Plus | Work RVUs3 | Equals | Total Work RVUs |
| 37256 | PTA (Complex) |
10.75 |
+ |
3.0 |
= |
13.75 |
| 37260 | Stent (Complex) |
12.69 |
+ |
3.0 |
= |
15.69 |
| Without Peripheral IVL | With Peripheral IVL2 | |||||
| CPT® | Description | Work RVUs3 | Plus | Work RVUs3 | Equals | Total Work RVUs |
| 37265 | PTA (Complex) |
10.50 |
+ |
4.0 |
= |
14.50 |
| 37269 | Stent (Complex) |
14.75 |
+ |
4.0 |
= |
18.75 |
| 37273 | Atherectomy (Complex) |
12.63 |
+ |
4.0 |
= |
16.63 |
| 37277 | Stent + Atherectomy (Complex) |
15.00 |
+ |
4.0 |
= |
19.00 |
RVU: Relative Value Units
CPT (R) 2025 American Medical Association. All rights reserved. CPT (R) is a registered trademark of the American Medical Association.
1: Peripheral IVL CPT add-on codes 37262 and 37279 may be used with all primary CPT codes for peripheral interventions. For a complete description of appropriate use of 37262 and 37279, please refer to the most current edition of the CPT codebook from AMA CPT Editorial Panel.
2: Primary Procedure Code + Peripheral IVL CPT® Add-on Codes (37262 or 37279).
3: CMS-1832-F; Medicare Physician Fee Schedule, MPFS, Calendar Year 2026 Final Rule. 10/31/25, Addendum B, using conversion factor 33.4009.
Hospital Outpatient & Ambulatory Surgical Centers
Dedicated Hospital Outpatient and Ambulatory Surgery Center codes and payment are available for IVL performed both above-the-knee (iliac, femoral, and popliteal arteries) and below-the-knee (infrapopliteal arteries).
2026 Rates Effective January 1, 2026
Accordion Section
The table below contains a list of possible HCPCS codes that may be used to bill for IVL in the hospital outpatient setting.
| Code | Description | Medicare 2026 National Payment1 |
| C9764 | Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with Intravascular Lithotripsy, includes angioplasty within the same vessel(s), when performed | $11,794 |
| C9765 | Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with Intravascular Lithotripsy, and transluminal stent placement(s), includes angioplasty within the same vessel(s), when performed | $18,729 |
| C9766 | Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with Intravascular Lithotripsy and atherectomy, includes angioplasty within the same vessel(s), when performed | $18,729 |
| C9767 | Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with Intravascular Lithotripsy and transluminal stent placement(s), and atherectomy, includes angioplasty within the same vessel(s), when performed | $18,729 |
| C9772 | Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies), with Intravascular Lithotripsy, includes angioplasty within the same vessel(s), when performed | $11,794 |
| C9773 | Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with Intravascular Lithotripsy, and transluminal stent placement(s), includes angioplasty within the same vessel(s), when performed | $18,729 |
| C9774 | Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with Intravascular Lithotripsy and atherectomy, includes angioplasty within the same vessel(s), when performed | $18,729 |
| C9775 | Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with Intravascular Lithotripsy and transluminal stent placement(s), and atherectomy, includes angioplasty within the same vessel(s), when performed | $18,729 |
Complexity adjustments may exist for some code combinations with C9764 and C9772. For detailed information on complexity adjustments, refer to the 2026 Peripheral IVL Hospital & ASC Coding Guide or contact your Shockwave Medical reimbursement specialist.
1: CMS-1834-FC, Addenda B,D1; SI of J1 = Comprehensive APC. All covered services on the claim are packaged with the primary “J1” service on the claim.
*It is important to note that the C-codes are designed to identify the entire procedure, and not just the IVL catheter, when IVL is performed in revascularization procedures. Hospital and ASC charges for the HCPCS codes should reflect charges for the entire procedure similar to other lower extremity revascularization procedures, including charges associated with the IVL catheter.
The table below contains a list of possible HCPCS codes that may be used to bill for IVL in the ASC setting.
| Code | Description | Medicare 2026 National Payment1 |
| C9764 | Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with Intravascular Lithotripsy, includes angioplasty within the same vessel(s), when performed | $8,249 |
| C9765 | Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with Intravascular Lithotripsy, and transluminal stent placement(s), includes angioplasty within the same vessel(s), when performed | $13,269 |
| C9766 | Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with Intravascular Lithotripsy and atherectomy, includes angioplasty within the same vessel(s), when performed | $13,628 |
| C9767 | Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with Intravascular Lithotripsy and transluminal stent placement(s), and atherectomy, includes angioplasty within the same vessel(s), when performed | $13,908 |
| C9772 | Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies), with Intravascular Lithotripsy, includes angioplasty within the same vessel(s), when performed | $8,000 |
| C9773 | Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with Intravascular Lithotripsy, and transluminal stent placement(s), includes angioplasty within the same vessel(s), when performed | $12,025 |
| C9774 | Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with Intravascular Lithotripsy and atherectomy, includes angioplasty within the same vessel(s), when performed | $13,064 |
| C9775 | Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with Intravascular Lithotripsy and transluminal stent placement(s), and atherectomy, includes angioplasty within the same vessel(s), when performed | $14,121 |
1: CMS-1834-FC; Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgery Center (ASC) Payment System Calendar Year 2026 Final Rule, Addenda AA
Hospital Inpatient
Medicare reimburses acute inpatient care under the FY2026 IPPS, which utilizes the MS-DRG system for payment. When Peripheral IVL is performed in the hospital inpatient setting, the hospital discharge is typically assigned to one of of the MS-DRGs listed below. Performance of additional procedures may change the MS-DRG assignment. The below FY2026 payments are effective as of October 1, 2025.
2026 Rates Effective October 1, 2025
Accordion Section
The table below contains a list of possible ICD 10-PCS codes that may be used to bill for IVL.
| Code | Description |
| 04FC3ZZ | Fragmentation of right common iliac artery, percutaneous approach |
| 04FE3ZZ | Fragmentation of right internal iliac artery, percutaneous approach |
| 04FH3ZZ | Fragmentation of right external iliac artery, percutaneous approach |
| 04FK3ZZ | Fragmentation of right femoral iliac artery, percutaneous approach |
| 04FM3ZZ | Fragmentation of right popliteal artery, percutaneous approach |
| 04FP3ZZ | Fragmentation of right anterior tibial artery, percutaneous approach |
| 04FR3ZZ | Fragmentation of right posterior tibial artery, percutaneous approach |
| 04FT3ZZ | Fragmentation of right peroneal artery, percutaneous approach |
| 04FD3ZZ | Fragmentation of left common iliac artery, percutaneous approach |
| 04FF3ZZ | Fragmentation of left internal iliac artery, percutaneous approach |
| 04FJ3ZZ | Fragmentation of left external iliac artery, percutaneous approach |
| 04FL3ZZ | Fragmentation of left femoral artery, percutaneous approach |
| 04FN3ZZ | Fragmentation of left popliteal artery, percutaneous approach |
| 04FQ3ZZ | Fragmentation of left anterior tibial artery, percutaneous approach |
| 04FS3ZZ | Fragmentation of left posterior tibial artery, percutaneous approach |
| 04FU3ZZ | Fragmentation of left peroneal artery, percutaneous approach |
| 04FY3ZZ | Fragmentation of lower artery, percutaneous approach |
2026 Medicare Inpatient Peripheral Reimbursement Updates
The Medicare Inpatient Prospective Payment System (IPPS) Fiscal Year 2026 (FY2026) final rule contained several payment updates. As compared to the prior year, the new rates associated with the peripheral IVL MS-DRGs 278 and 279 result in a national base payment increase of $4,798 for patients with MCC1 and $3,375 for patients with CC/none1 for peripheral interventions, effective October 1, 2025.
Peripheral Revascularization Procedures
Procedure: IVL
| MS-DRG | Description | Severity | FY2026 Medicare National Base Payment1 |
| 278 | Ultrasound accelerated & other thrombolysis of peripheral vascular structures | MCC | $40,504 |
| 279 | CC/None | $26,243 |
Procedure: Atherectomy
| MS-DRG | Description | Severity | FY2026 Medicare National Base Payment1 |
| 270 | Other Major Cardiovascular Procedures | MCC | $38,394 |
| 271 | CC | $25,878 | |
| 272 | None | $18,578 |
Procedure: PTA, DCB, Stent (Covered, BMS, DES)
| MS-DRG | Description | Severity | FY2026 Medicare National Base Payment1 |
| 252 | Other Vascular Procedures | MCC | $25,384 |
| 253 | CC | $18,888 | |
| 254 | None | $12,965 |
MCC: Major Complications and Comorbidities; CC: Complications and Comorbidities.
1: CMS-1833-F. MS-DRG Base Rates shown are based on Medicare Inpatient Prospective Payment System FY2026, Final Rule, Table 1 & Table 5. National base payment rates assume full update amount for hospitals which have submitted quality data and hospitals have a wage index greater than 1. Site specific payment rates will vary based on regional area wage differences, teaching hospital status, indirect medical education costs, quality data, and additional payments to hospitals that treat a large percentage of low-income patients (“disproportionate share payments”), etc. MS-DRG payment rates shown do not include sequestration reduction.
Shockwave Peripheral IVL Outpatient/ASC Reimbursement FAQs
Accordion Section
There is no IVL-specific supply code for our peripheral IVL catheters. Options for reporting include:
- C1889 – Implantable/insertable device, not otherwise classified or
- C1725 – Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability)
The HCPCS procedure codes associated with IVL were developed by CMS. Private/Commercial payers may not choose to recognize these codes. Appropriated pre-authorization and approval process should be followed prior to the procedure for all Medicare Advantage and Commercial payers.
Yes, the codes are specific to the use of IVL with and/or without the use of other associated technologies such as stenting, drug coated balloons, or atherectomy.
The coding, coverage, and payment information contained herein is gathered from various resources and is subject to change without notice. Shockwave Medical cannot guarantee success in obtaining third-party insurance payments. Third-party payment for medical products and services is affected by numerous factors. It is always the provider’s responsibility to determine and submit appropriate codes, charges, and modifiers for services that are rendered. Providers should contact their third-party payers for specific information on their coding, coverage, and payment policies. Amounts reflect the base payment rate before adjustments, including any sequestration or geographic adjustments. Payment rates are updated periodically by CMS, and the above information does not represent a guarantee of coverage or reimbursement.