Procedure coding
Typically, procedure coding for peripheral angioplasty is well established in European countries.
The coding for peripheral angioplasty may differ depending on the anatomical site of intervention (for example, in France and countries of the Nordic region) or the number of treated vessels (for example, in England, Germany, and Italy).
In some countries, procedure coding is complex, involving multiple codes depending on the type, number of inserted stents, and the number of treated vessels. For example, in Switzerland, a combination of CHOP codes for percutaneous angioplasty or atherectomy of other non-coronary vessel, along with insertion of a stent or drug-coated balloon, and multiple supplementary codes to specify the type (bare metal stent, drug-eluting stent, etc.), the number of inserted stents (ranging from one to six), and the number of treated vessels (from one to four or more) is used to describe the procedure.
In other countries, the number of procedure codes for PCI is limited. For example, in the Netherlands, the procedure is described via a single code for percutaneous angioplasty of non-coronary peripheral vessels (code 033672).
Payment mechanism
The payment model varies by country.
In most EU countries, stand-alone peripheral angioplasty with plain balloon or bare metal stent insertion is reimbursed solely via the diagnosis-related group (DRG) mechanism. In contrast, drug-coated balloons or drug-eluting stents attract additional reimbursement, paid on top of the DRG tariff. For example, in Germany, there are several add-on ZE subcategories for drug-releasing balloons depending on their number (with the range of tariffs from €179 to €1,403 in 2025). Add-on reimbursement can be either generic (at the class level, as in Germany) or brand-specific (with specific codes for drug-eluting peripheral stents and drug-coated balloons in Belgium).
In some countries (e.g., England, Germany, Italy), the DRG allocation and reimbursement amount for peripheral angioplasty depend on the number of treated vessels. For example, in England, the procedure on a single vessel is allocated to the HRG YR11D “Percutaneous Transluminal Angioplasty of Single Blood Vessel with CC Score 0-2” with a tariff of £1,486, while for multiple vessels, it is allocated to the HRG YR10C “Percutaneous Transluminal Angioplasty of Multiple Blood Vessels with CC Score 0-2,” which has a higher tariff of £1,940 in the 2025/26 financial year.
Policy considerations
Peripheral angioplasty, both with and without stenting, is a well-established technology unlikely to be subject to specific policies from payers or national decision-makers in countries where such frameworks exist.
Health technology assessment
Due to established reimbursement in European countries, devices for peripheral angioplasty rarely become subjects of HTA.
Future challenges
Peripheral angioplasty, with or without stent placement, is widely reimbursed and funded across most European countries. However, the introduction of newer peripheral stents and balloons – featuring novel designs, functionalities, or distinct cost profiles – often necessitates creating specific procedure codes and adjusting existing payment mechanisms. Robust evidence demonstrating clinical efficacy and cost-effectiveness is essential for adopting these innovative technologies to ensure appropriate reimbursement.
How can MTRC help?
Development of reimbursement analysis (procedure coding, payment mechanism, reimbursement tariffs, and policy considerations)
Development of market access strategy
Development of the value dossier
Performing evidence gap analysis for novel technologies
Development of reimbursement and HTA submission dossiers
Adaptation of the global health economic model to EU settings
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