Summary & Overview

CPT 34510: Venous Valve Repair and Graft Replacement

CPT code 34510 denotes surgical repair and replacement of a defective venous valve with a graft. This procedure is a targeted vascular surgery addressing valvular incompetence within a vein, with implications for patient mobility, chronic venous insufficiency management, and downstream costs associated with recurrent venous disease. Nationally, recognition and appropriate coding of this procedure affect clinical tracking, coverage determinations, and resource allocation for vascular surgical services.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and service setting, common payer coverage patterns, and benchmarks where available. The publication also summarizes coding considerations, typical sites of service, and commonly reported modifiers associated with surgical procedures of this type. Policy and reimbursement updates relevant to complex vascular procedures are highlighted to inform billing, administrative, and clinical staff about potential impacts on authorization and payment workflows.

This analysis is intended for a national audience of clinicians, coding professionals, and healthcare administrators seeking a focused briefing on the clinical meaning, billing context, and payer landscape for CPT code 34510.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare34510CPTvenous valve repairvascular surgerygraft replacementoperative proceduresurgical codinghospital inpatientambulatory surgery

Billing Code Overview

CPT code 34510 describes a surgical procedure to access a deficient venous valve, remove the defective valve, and replace it with a graft. The procedure requires an appropriate incision to reach the affected valve within the vein and reconstruction of the venous valve apparatus.

Service type: Surgical venous valve repair and replacement
Typical site of service: Operating room or surgical suite in an inpatient or outpatient hospital setting

Clinical & Coding Specifications

Clinical Context

A 62-year-old patient presents with progressive chronic venous insufficiency of the lower extremity characterized by symptomatic venous reflux, recurrent venous ulceration, and pain refractory to conservative therapy. After duplex ultrasonography confirms incompetent deep venous valves in the femoral or popliteal vein segment, the vascular surgeon schedules an open valvuloplasty with valve replacement using a venous graft. In the operating room under general or regional anesthesia, the surgeon makes an appropriate incision to expose the defective valve in the affected vein, excises the diseased valve tissue, and interposes a graft (autogenous or synthetic) to reconstruct or replace the valve. Typical perioperative workflow includes preoperative vascular laboratory testing, perioperative antibiotic prophylaxis, intraoperative hemostasis and graft sizing, and postoperative Doppler evaluation with instructions for anticoagulation, wound care, and ulcer management when applicable. Typical site of service is an inpatient or ambulatory surgical center with vascular surgery capability depending on patient comorbidity and complexity. Service type: open vascular surgery (vein valvular repair/replacement).

Coding Specifications

Modifier	Description	When to Use
`11`	Physician inpatient/outpatient service	Use when the primary surgeon is reporting the normal postoperative care and global surgical package applies.

Taxonomy Code	Specialty	Notes
2080P0800X	Vascular Surgery	Primary specialty performing open venous valve repair/replacement.
208D00000X	General Surgery	General surgeons with vascular training may perform this procedure in some settings.
207RH0000X	Interventional Radiology	Typically performs endovascular alternatives; may be involved in diagnostics or hybrid procedures.
363L00000X	Physician Assistant	PAs commonly assist in vascular procedures and perioperative care.
364S00000X	Nurse Practitioner	NPs involved in preoperative and postoperative management.

ICD-10 Code	Description	Clinical Relevance
`I87.2`	Chronic venous insufficiency (peripheral)	Primary indication for surgical correction of incompetent venous valves causing edema, pain, or ulceration.
`I83.90`	Varicose veins of unspecified lower extremity with unspecified complication	Frequently associated venous pathology that may coexist with valve incompetence necessitating surgical intervention.
`I83.10`	Varicose veins of right lower extremity with ulcer	Indicates advanced disease where valve repair or grafting may be required to promote ulcer healing.
`I83.11`	Varicose veins of left lower extremity with ulcer	Same clinical relevance for the contralateral limb.
`L97.909`	Non-pressure chronic ulcer of unspecified part of unspecified lower leg with unspecified severity	Chronic venous ulcers often drive the need for definitive venous valve surgery when conservative care fails.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`35476`	Vein repair, bypass graft, femoral to popliteal; with prosthetic graft	May be used when a bypass with prosthetic graft is performed for extensive venous reconstruction instead of isolated valve replacement.
`35500`	Excision of malignant or benign vascular lesion; open	May be reported for excision of adjacent vascular lesions encountered during exposure (rarely paired; use caution with bundling rules).
`36215`	Selective catheter placement, arterial system; each first order thoracic, abdominal, pelvic, or lower extremity branch, percutaneous, with radiological supervision and interpretation	Used when intraoperative angiography or venography is performed to assess venous anatomy and graft patency.
`93970`	Duplex scan of extremity veins, complete bilateral study	Preoperative and postoperative duplex surveillance to document reflux and graft function.
`99152`	Moderate sedation services provided by the same physician or other qualified health care professional performing a procedure; initial 15 minutes intra-service time, patient age 5 years or older	Use when moderate sedation is furnished by the operating provider during the procedure (bill per payer policy).
`99223`	Initial hospital care, typically 70 minutes or more	Use for admitting and initial hospital evaluation for complex inpatient surgical management when applicable.

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