CPT 34501 Femoral Vein Valve Repair Reimbursement | OpenPayer

Summary & Overview

CPT 34501: Femoral Vein Valve Repair via Thigh Incision

CPT code 34501 represents a femoral vein valve repair performed via an incision in the thigh to access and repair the femoral vein valve. This vascular surgical procedure is used to correct venous valve dysfunction in the lower extremity, which can affect mobility, venous return, and long-term limb health. Nationally, correct coding of this operative procedure is important for clinical documentation, quality reporting, and consistent reimbursement across hospital and ambulatory surgical settings.

Key payers included in the coverage analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a concise overview of clinical context for 34501, standard sites of service, and what stakeholders should expect in terms of coding classification and reporting.

Readers will learn the clinical intent of the procedure, the typical care setting, and which major payers are referenced in coverage discussions. Where available, the report highlights benchmark considerations and policy updates relevant to vascular surgery billing and documentation. Data not available in the input is explicitly noted where necessary.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare34501CPTvascular surgeryfemoral veinvein repairambulatory surgeryhospital servicessurgical coding

Billing Code Overview

CPT code 34501 describes a surgical procedure in which the physician makes an incision in the thigh to access and repair the femoral vein valve. This procedure is a vascular surgical repair focused on the femoral vein valve to restore or improve venous function in the lower extremity.

Service type: Surgical vascular repair
Typical site of service: Hospital operating room or ambulatory surgery center

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A typical patient is a 58-year-old with chronic venous insufficiency and symptomatic femoral vein valve incompetence presenting with persistent thigh swelling, pain, and recurrent venous stasis changes despite conservative measures (compression therapy, leg elevation, and medical management). The vascular surgeon evaluates duplex venous ultrasound confirming reflux of the common or superficial femoral vein valve. After preoperative assessment and anesthesia clearance, the patient is scheduled for open femoral vein valve repair under general or regional anesthesia. In the operating room the surgeon makes an incision in the medial thigh to expose the femoral vein, isolates the incompetent valve segment, performs valvuloplasty or valve repair techniques (e.g., leaflet plication, commissuroplasty), confirms competence with saline infusion or intraoperative duplex, achieves hemostasis, and closes in layers. Postoperative workflow includes recovery room monitoring, venous thromboembolism prophylaxis, limb elevation, wound checks, and outpatient follow-up with duplex imaging to assess valve competence and wound healing.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier (standard reporting)	Use when no specific modifier applies and the service is reported normally.
`11`

CPT 34510: Venous Valve Repair and Graft Replacement

CPT-34502-VENA-CAVA-RECONSTRUCTION

CPT 34502: Vena Cava Reconstruction

CPT-34520-VENOUS-ANASTOMOSIS-DIVISION-AND-ATTACHMENT

CPT 34520: Venous Anastomosis with Division and Attachment

CPT-34530-SAPHENOUS-TO-POPLITEAL-VEIN-ANASTOMOSIS

CPT 34530: Saphenous-to-Popliteal Vein Anastomosis

Taxonomy Code	Specialty	Notes
`208100000X`	Vascular Surgery	Primary specialty performing femoral vein valve repair.
`207K00000X`	General Surgery	May perform venous surgery including femoral vein repairs in some practices.
`2080S0127X`	Thoracic and Cardiovascular Surgery (Vascular)	Cardiothoracic/vascular surgeons who treat complex venous disease.
`208D00000X`	Interventional Cardiology	May be involved in hybrid cases or endovascular adjunctive procedures.
`207L00000X`	Plastic Surgery	Occasionally involved for complex soft tissue or wound closure when needed.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I87.2`	Venous insufficiency (chronic) (peripheral)	Primary indication when femoral vein valve incompetence causes chronic venous insufficiency with symptoms.
`I83.219`	Varicose veins of bilateral lower extremities with ulcer of unspecified thigh, unspecified lower extremity	Significant venous disease with skin breakdown that may prompt corrective venous procedures including valve repair.
`I83.10`	Varicose veins of right lower extremity with other complications	Associated superficial venous disease frequently treated in conjunction with deep venous valve pathology.
`I80.2`	Phlebitis and thrombophlebitis of other deep vessels of lower extremities	Prior or recurrent DVT can damage valves and lead to secondary valve incompetence requiring repair.
`I97.2`	Postprocedural venous complications	Used when complications from prior venous procedures contribute to valve dysfunction or need for revision.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`37184`	Endovenous laser ablation, open or percutaneous, attention to superficial vein insufficiency; single extremity	Often performed before or after valve repair to treat associated superficial venous reflux.
`36475`	Endovenous ablation therapy of incompetent vein, radiofrequency, vein; complete ablation of incompetent great saphenous vein	Alternative or adjunct for superficial vein treatment in the same care episode.
`35301`	Ligation, proximal occlusion, or excision of incompetent vein (e.g., femoral vein tributary/ligation)	May be performed concurrently when tributary ligation is required alongside valve repair.
`35820`	Revision, repair of arteriovenous fistula; with direct anastomosis or interposition graft, vein	Related vascular repair code for complex venous reconstructions when grafting or revision is needed.
`99160`	Anesthesia for patient of extreme age, younger than 1 year and older than 70 years, when specified by anesthesia report	Anesthesia-related code relevant for older patients requiring special anesthesia documentation.

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