CPT 34101 Upper‑Extremity Thrombectomy Reimbursement | OpenPayer

Summary & Overview

CPT 34101: Removal of Obstruction from Axillary/Brachial/Subclavian/Innominate Artery

CPT code 34101 represents a surgical removal of an obstruction (such as an atheromatous plaque or thrombus) from major upper-extremity and central upper-chest arteries — specifically the axillary, brachial, subclavian, or innominate artery. This procedure is a critical vascular intervention used to restore arterial blood flow to the arm and prevent ischemic complications. Nationally, accurate coding for procedures like 34101 matters for quality reporting, appropriate reimbursement, and tracking utilization of vascular surgical services.

Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, typical sites of service, and the service type tied to the code. The publication also summarizes typical payer coverage considerations and common modifier usage where available. Additionally, the report provides benchmarks and policy-relevant notes to support revenue cycle, compliance, and clinical documentation efforts. Data not available in the input are clearly indicated where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 34101vascular surgerythrombectomyupper extremityarterial occlusionoperating roomendovascular-assistedprocedure coding

Billing Code Overview

CPT code 34101 describes a surgical procedure to remove an obstruction (for example, a fatty deposit or blood clot) from the axillary, brachial, subclavian, or innominate artery. The provider gains access to the affected artery by making an incision in the patient’s arm and may use a catheter to assist in removal.

Service type: Surgical arterial thrombectomy/endarterectomy of upper extremity/central upper chest arteries
Typical site of service: Operating room or vascular surgery suite; may also be performed in an interventional suite when catheter assistance is used

Data not available in the input for payers, associated taxonomies, ICD-10 diagnoses, and related codes.

Clinical & Coding Specifications

Clinical Context

A patient in their 60s presents to the emergency department with acute onset of severe pain, pallor, and decreased pulses in the left upper extremity. Physical exam and Doppler ultrasound suggest an acute arterial occlusion of the axillary/brachial artery, confirmed by CT angiography showing a thromboembolic occlusion of the axillary artery. The vascular surgery team evaluates the patient and determines urgent surgical thrombectomy is required to restore perfusion.

Preoperative workflow includes informed consent, limb viability assessment, baseline labs (CBC, coagulation panel, type and screen), and perioperative antibiotics per institutional protocol. In the operating room under regional or general anesthesia, the surgeon makes an incision in the upper arm to expose the axillary/brachial artery, controls proximal and distal flow with vessel loops or clamps, performs arteriotomy, and removes thrombus or embolus using manual extraction and, when indicated, a Fogarty catheter. Completion angiography or intraoperative Doppler confirms restoration of flow. The arteriotomy is repaired primarily or with patch angioplasty. Postoperative care includes monitoring for reperfusion injury, serial neurovascular checks, anticoagulation management, and wound care. Typical site of service: operating room in an acute care hospital (inpatient or same-day observation). Service type: open surgical arterial thrombectomy/embolectomy of axillary/brachial/subclavian/innominate arteries.

Coding Specifications

Modifier	Description	When to Use
`26`

CPT 34203: Peripheral Arterial Thrombectomy, Popliteal–Tibio–Peroneal Segment

CPT-34111-FOREARM-ARTERIAL-THROMBECTOMY-EMBOLECTOMY

CPT 34111: Forearm Arterial Thrombectomy/Embolectomy

CPT-34001-CERVICAL-ARTERY-THROMBECTOMY-EMBOLECTOMY

CPT 34001: Surgical Removal of Cervical Arterial Obstruction

CPT-34201-FEMOROPOPLITEAL-AORTOILIAC-THROMBECTOMY

CPT 34201: Femoropopliteal/Aortoiliac Arterial Thrombectomy

CPT-34051-SUBCLAVIAN-INNOMINATE-ARTERY-THROMBECTOMY-EMBOLECTOMY

CPT 34051: Subclavian and Innominate Artery Thrombectomy/Embolectomy

CPT-34151-OPEN-ARTERIAL-THROMBECTOMY-ABDOMINAL-VISCERAL-AORTOILIAC

CPT 34151: Open Arterial Thrombectomy, Abdominal Visceral or Aortoiliac Arteries

Taxonomy Code	Specialty	Notes
207K00000X	Vascular Surgery	Primary specialty performing arterial thrombectomy and arterial repairs.
2080P0006X	General Surgery	General surgeons with vascular expertise may perform upper extremity arterial embolectomy in emergent settings.
207L00000X	Thoracic and Cardiovascular Surgery	May perform procedures involving proximal subclavian or innominate arteries in complex cases.
2084P0800X	Interventional Cardiology	May be involved for endovascular adjuncts or hybrid procedures; not typically primary for open thrombectomy.
207RP0000X	Plastic and Reconstructive Surgery	Occasionally involved for complex soft tissue exposures or reconstructions following vascular access or wound issues.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I74.3`	Embolism and thrombosis of arteries of upper extremity	Direct indication for embolectomy/thrombectomy of axillary or brachial arteries.
`I74.01`	Embolism and thrombosis of right axillary artery	Site-specific code for right-sided axillary arterial occlusion requiring removal of thrombus.
`I74.02`	Embolism and thrombosis of left axillary artery	Site-specific code for left-sided axillary arterial occlusion requiring intervention.
`I65.22`	Occlusion and stenosis of left brachial artery	Chronic or acute occlusive disease of the brachial artery that may require surgical thrombectomy.
`I65.21`	Occlusion and stenosis of right brachial artery	As above for the right brachial artery.
`I73.9`	Peripheral vascular disease, unspecified	Underlying peripheral arterial disease that may predispose to thrombosis or embolic events leading to surgical intervention.
`T82.8XXA`	Other complications of vascular prosthetic devices, implants and grafts, initial encounter	Relevant if thrombus is associated with prior vascular graft or device requiring operative removal.
`I80.1`	Phlebitis and thrombophlebitis of other deep vessels of lower extremities	Not directly an upper-extremity arterial code but included only if venous thromboembolic disease contributes to embolic risk. (Included with caution.)

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`37135`	Percutaneous transluminal mechanical thrombectomy, noncoronary, arterial or venous, including radiologic supervision and interpretation when performed	Used when a percutaneous mechanical thrombectomy is performed as an endovascular alternative or adjunct to open surgical thrombectomy.
`35005`	Thrombectomy, femoral artery; with embolectomy, with or without arteriotomy and/or angioplasty (separate regional entry example)	Represents thrombectomy codes for a different anatomic site; listed as a comparable open arterial embolectomy technique and for coding cross-reference when multiple sites are treated.
`35476`	Embolectomy, peripheral, by catheter, percutaneous	Represents catheter embolectomy techniques that may be used adjunctively through percutaneous access.
`75989`	Angiography, vascular, other; non-selective catheter placement, radiological supervision and interpretation	Used for intraoperative or pre-/postoperative angiography to confirm vessel patency when imaging is performed.
`35201`	Thrombectomy, artery, direct exposure; for vessels of the upper extremity (example code family)	Related open arterial thrombectomy family code for coding crosswalks—used when specific anatomic descriptor differs; supports documentation of open arterial removal of thrombus.
`36248`	Selective catheter placement, arterial system; each first order thoracic branch, radiological supervision and interpretation	Used if selective catheter angiography of subclavian/innominate branches is performed intraoperatively or preoperatively as part of the workup.

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