05/13/2026
Federal Alert for Vascular Physicians: OIG Report + RAC Audits Put Three Key Procedure Categories in the Crosshairs
Vascular specialists and interventional radiologists billing under Medicare are facing enforcement pressure from two directions at once — and if you perform office-based procedures, you need to act now.
OIG Report — $105 Million in Questioned Payments
On May 5, 2026, the OIG released a landmark report on peripheral vascular procedures (angioplasty, stenting, atherectomy) performed in office-based laboratories (OBLs). Key findings:
$105 million in Medicare payments flagged as potentially medically unnecessary
Just 26 physicians accounted for 61% of concerning payments
75% of atherectomy and 47% of tibial artery procedures performed in OBLs
CMS has agreed to monitor billing AND follow up with identified physicians
RAC Auditors Are Now Targeting Selective Catheter Placement
Separately, RAC auditors have added selective catheter placement — including angiograms and vascular embolizations — as an active audit target. CPT codes under direct scrutiny:
CPT 36247 – Selective catheter placement, third order or more
CPT 37229 – Endovascular revascularization, tibial/peroneal artery
Together, these developments mean that angioplasty, stenting, atherectomy, selective catheterization, angiograms, and vascular embolizations are all now under active federal review.
What's already happening:→ RAC, ZPIC, and MAC contractors ramping up audit activity → CMS following up with physicians already flagged by OIG → False Claims Act enforcement in motion — one vascular practice just settled for $6.73M
WCH Service Bureau can help you get ahead of this.
We offer a proactive pre-audit compliance review covering all targeted procedure categories — claims review, medical necessity documentation, utilization pattern analysis, corrective action planning, and staff education.
FREE Sample Audit — No Commitment, No Risk
Send us 2–3 patient records, and we'll show you exactly where you stand — at no charge.
https://wchsb.com/contact-form/
