Summary & Overview
CPT 34051: Subclavian and Innominate Artery Thrombectomy/Embolectomy
CPT code 34051 denotes a thoracic surgical arterial thrombectomy or embolectomy to remove an obstruction from the subclavian and innominate arteries. This invasive vascular procedure is clinically significant because prompt removal of arterial occlusion can restore limb and cerebral perfusion and prevent ischemic complications. Nationally, the code captures high-acuity vascular surgery services typically performed in operating rooms or thoracic surgical suites.
Key payers referenced include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical and billing framing of CPT code 34051, including service context, typical sites of service, and common procedural considerations relevant to claims adjudication and coding accuracy. The publication outlines benchmarks and payment context where available, notes common modifiers and billing scenarios affecting reimbursement, and summarizes policy or coding guidance impacting use of this code.
The content is intended for coding professionals, vascular and thoracic surgeons, revenue cycle staff, and policy analysts seeking a national-level understanding of how CPT code 34051 is used in clinical and billing workflows, and what factors commonly influence coverage and payment.
Billing Code Overview
CPT code 34051 describes a surgical procedure to remove an obstruction, such as a thrombus or embolus, from the subclavian and innominate artery. The surgeon reaches the target artery through an incision in the thorax and may perform the removal with or without the use of a catheter.
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Service type: Surgical arterial thrombectomy/embolectomy involving the subclavian and innominate arteries
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Typical site of service: Inpatient or outpatient surgical setting with access to an operating room or thoracic surgical suite; procedure approach requires thoracic incision and vascular surgical capabilities
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting with acute upper extremity ischemia due to an embolus or thrombus lodged in the subclavian or innominate artery. The patient often arrives from the emergency department with sudden arm pain, pallor, paresthesia, decreased pulses, and delayed capillary refill. Initial evaluation includes vascular exam, duplex ultrasonography, and CT angiography to localize the obstruction. The vascular surgery team evaluates the patient and determines that open surgical thrombectomy/thromboembolectomy via a transthoracic approach is required because the clot is proximal in the subclavian or innominate artery and cannot be accessed peripherally or managed endovascularly.
Perioperative workflow includes informed consent, preoperative labs and crossmatch if significant bleeding risk is anticipated, anesthesia evaluation (general anesthesia is typical), and intraoperative vascular access. The surgeon makes a thoracic incision to expose the artery, performs embolectomy or thrombectomy with or without use of a catheter or Fogarty balloon, achieves hemostasis, and closes the incision. Postoperative care includes vascular monitoring, anticoagulation management, wound care, and surveillance imaging as indicated. Typical site of service is an inpatient operating room; the service type is an open surgical thrombectomy/thromboembolectomy of a thoracic great vessel.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component |