Summary & Overview
CPT 34201: Femoropopliteal/Aortoiliac Arterial Thrombectomy
CPT code 34201 represents a surgical arterial thrombectomy performed through a leg incision to access the femoropopliteal or aortoiliac artery and remove a clot, with or without catheter assistance. The code captures a definitive open or direct approach to arterial thrombus removal and is used in acute limb ischemia and other occlusive arterial conditions where endovascular-only techniques are insufficient.
This national overview covers common public and private payers including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context for when the procedure is billed, typical sites of service, and how the code fits into vascular surgery service lines. The publication outlines common modifiers associated with surgical procedures and notes missing input fields where applicable.
The report provides benchmarks and policy-relevant information for billing teams, revenue cycle managers, and vascular surgery clinicians: frequency and utilization patterns, payer coverage considerations, and documentation elements typically associated with surgical thrombectomy coding. Data not available in the input is noted where relevant, and the focus remains on national billing and clinical context rather than state-level specifics.
Billing Code Overview
CPT code 34201 describes a surgical thrombectomy performed via a leg incision with direct entry into the femoropopliteal or aortoiliac artery to remove a thrombus, with or without catheter assistance. This procedure is a form of open or direct arterial thrombectomy.
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Service type: Surgical arterial thrombectomy
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Typical site of service: Operating room or vascular surgery suite, often in a hospital inpatient or outpatient surgical setting
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting to the vascular surgery service with acute limb ischemia of the lower extremity characterized by sudden onset pain, pallor, pulselessness, paresthesia, poikilothermia, and paralysis. The patient often arrives from the emergency department or clinic after diagnostic imaging (duplex ultrasound, CT angiography) demonstrates thromboembolic or thrombotic occlusion of the femoropopliteal arterial segment. Preoperative evaluation includes anticoagulation status, vascular exam, baseline labs, and informed consent for open thrombectomy of the femoropopliteal artery.
The clinical workflow: initial evaluation in ED or clinic → vascular imaging confirming arterial occlusion → perioperative anticoagulation and optimization → transport to operating room or vascular suite → regional or general anesthesia → longitudinal or transverse incision over the femoral artery, arteriotomy and removal of thrombus using Fogarty balloon catheter (with or without adjunctive catheter-directed techniques) → intraoperative assessment of flow with completion angiography or duplex → vessel repair (patch angioplasty or primary repair) and wound closure → postoperative monitoring in PACU or floor with anticoagulation and vascular checks, and planning for follow-up imaging and rehabilitation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When reporting only the physician’s professional work if the technical component is billed separately |