Summary & Overview
CPT 34151: Open Arterial Thrombectomy, Abdominal Visceral or Aortoiliac Arteries
CPT code 34151 denotes an open surgical thrombectomy or embolectomy of abdominal visceral or aortoiliac arteries, involving an abdominal incision and direct removal of an arterial clot with or without catheter assistance. This procedure is clinically important for reestablishing perfusion to kidneys, intestines, or pelvic structures and can be lifesaving or organ-preserving in acute arterial occlusion. Nationally, appropriate coding for this procedure affects hospital billing, surgical quality reporting, and resource utilization for vascular and general surgery services.
Key payers considered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of clinical indications and typical sites of service, guidance on common billing modifiers and coding context, and comparative benchmarks where available. The publication outlines common documentation elements that justify the use of CPT code 34151, highlights related procedure groupings, and summarizes payer coverage considerations and prior authorization patterns when public information is available. The piece also provides a brief look at procedural variations — open versus catheter-assisted techniques — and how those differences map to coding and billing practice.
Data not available in the input: Associated taxonomies, ICD-10 diagnoses, related codes, and service-line financial benchmarks.
Billing Code Overview
CPT code 34151 describes a surgical thrombectomy in which the provider makes an incision in the abdomen, accesses a major abdominal artery (renal, celiac, mesenteric, or aortoiliac), and removes an occluding clot with or without use of a catheter. This procedure restores arterial blood flow to downstream organs or tissues by direct removal of thrombus from the affected visceral or aortoiliac vessel.
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Service type: Open surgical arterial thrombectomy / embolectomy of abdominal visceral or aortoiliac arteries
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Typical site of service: Hospital operating room or hybrid operating room (inpatient or inpatient-originating procedure depending on clinical context)
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with a history of atrial fibrillation on anticoagulation presents to the emergency department with sudden onset severe left flank pain, decreased urine output, and hematuria. Imaging with contrast-enhanced CT angiography demonstrates an acute thromboembolus occluding the left renal artery with evidence of renal ischemia. The vascular surgery team evaluates the patient and determines endarterectomy/thrombectomy via open surgical exposure of the renal artery is indicated due to proximal occlusion and failed endovascular attempt. The patient is taken to the operating room, placed under general anesthesia, and an abdominal incision is made to expose the renal artery. Direct arterial arteriotomy is performed and the thrombus is removed with vascular clamps and suction with or without adjunctive catheter-directed extraction. Hemostasis is secured, the artery repaired, and the abdomen closed. Postoperative care includes monitoring in a surgical ward or intensive care unit, serial renal function assessment, anticoagulation management, and imaging as indicated to confirm restoration of perfusion.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the physician’s professional work separate from technical facility resources (rare for this surgical procedure). |