CPT 34705 Aorto–bi–iliac Endograft Reimbursement | OpenPayer

Summary & Overview

CPT 34705: Aorto–bi–iliac Endograft Placement for Infrarenal Aortic Repair

CPT code 34705 denotes placement of an aorto–bi–iliac endograft — a complex endovascular, Y‑shaped graft extending from the infrarenal aorta into both iliac arteries — for repair of the infrarenal aorta or iliac artery when not related to rupture or traumatic injury. This procedural code includes pre‑procedure sizing and device selection, nonselective catheterization, adjunct angioplasty or stenting, any necessary endograft extensions from the renal arteries to the iliac bifurcation, and radiological supervision and interpretation. Nationally, 34705 captures high‑complexity endovascular aortic repairs that concentrate in hospital operating rooms and hybrid endovascular suites and are relevant to vascular surgery, interventional radiology, and inpatient surgical service lines.

Payers referenced in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the procedure and clinical context, an outline of typical sites of service and service type, and a summary of common billing considerations and modifiers where Data not available in the input prevents a full payer‑specific reimbursement table. The publication also points to related operational elements such as device selection and imaging requirements that commonly affect coding and billing workflows. This overview is intended for a national audience of clinicians, hospital coding teams, and payer policy analysts seeking clear, procedure‑level context for CPT code 34705.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare34705CPTendovascular repairaorto-bi-iliac endograftvascular surgeryendograft placementhybrid ORangioplastyradiology supervision

Billing Code Overview

CPT code 34705 describes placement of an aorto–bi–iliac endograft — a Y‑shaped endovascular tube graft extending from the infrarenal aorta into both iliac arteries — performed to repair the infrarenal aorta or iliac artery for reasons other than rupture or injury. The code encompasses pre‑procedure sizing and device selection, any nonselective catheterization, angioplasty or stenting, endograft extensions from the renal arteries to the iliac bifurcation, and all radiological supervision and interpretation.

Service type: Endovascular aortic repair procedure (complex endovascular graft placement)
Typical site of service: Hospital operating room or hybrid endovascular suite with fluoroscopic imaging

Clinical & Coding Specifications

Clinical Context

A 72-year-old male with a history of hypertension, hyperlipidemia, and peripheral arterial disease presents with a symptomatic 5.8 cm infrarenal abdominal aortic aneurysm discovered on surveillance imaging. Preoperative CTA demonstrates adequate proximal and distal landing zones with extension into both common iliac arteries. The vascular surgery team schedules an elective endovascular repair using an aorto–bi–iliac endograft to exclude the aneurysm while preserving bilateral iliac perfusion. Pre-procedure workflow includes preoperative evaluation and medical optimization, computed tomography angiography for device sizing and planning, informed consent, selection of an appropriately sized Y-shaped endograft, and scheduling of intraoperative fluoroscopic guidance and potential adjunctive iliac stenting. The procedure is performed in an endovascular suite or hybrid operating room with general or monitored anesthesia care. Post-procedure workflow includes completion angiography with radiology supervision and interpretation, access site closure, post-anesthesia recovery, inpatient or short-observation monitoring for hemodynamic stability and limb perfusion, discharge planning with imaging follow-up (CTA or duplex) and secondary prevention measures.

Coding Specifications

Modifier	Description	When to Use
`00`	(Placeholder national; not commonly used clinically)	Data not available in the input.

CPT 34707: Ilio–iliac Tube Endograft for Iliac Artery Repair

CPT-34717-BRANCHED-ILIAC-ENDOGRAFT-PLACEMENT-ADJUNCT

CPT 34717: Branched Iliac Endograft Placement, Adjunct to Aortoiliac Endograft

CPT-34710-ENDOVASCULAR-TUBE-GRAFT-INFRARENAL-AORTIC-ILIAC

CPT 34710: Extension Prosthesis (Tube Graft) for Infrarenal Aortic/Iliac Repair

CPT-34718-BRANCHED-ILIAC-ENDOGRAFT-PLACEMENT-UNILATERAL

CPT 34718: Branched Iliac Endograft Placement, Unilateral

CPT-34713-PERCUTANEOUS-FEMORAL-SHEATH-FOR-ENDOGRAFT-DELIVERY

CPT 34713: Percutaneous Femoral Sheath for Endograft Delivery

CPT-34702-AORTO-AORTIC-TUBE-ENDOGRAFT-RUPTURED-INFRARENAL-AORTA

CPT 34702: Aorto–Aortic Tube Endograft for Ruptured Infrarenal Aorta

CPT-34832-OPEN-REPAIR-AFTER-FAILED-ENDOVASCULAR-INFRARENAL-AORTA

CPT 34832: Open Aorto–Bifemoral Repair After Failed Endovascular Aortic Repair

CPT-34709-INFRARENAL-AORTIC-ILIAC-EXTENSION-PROSTHESIS-TUBE-GRAFT

CPT 34709: Extension Prosthesis (Tube Graft) for Infrarenal Aortic/Iliac Repair

CPT-34714-FEMORAL-ARTERY-CONDUIT-FOR-ENDOVASCULAR-DELIVERY-OR-CPB

CPT 34714: Femoral Artery Conduit for Endovascular Delivery or CPB

CPT-34808-ILIAC-ARTERY-OCCLUSIVE-DEVICE-PLACEMENT-ADD-ON

CPT 34808: Iliac Artery Occlusive Device Placement, Add-On

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Taxonomy Code	Specialty	Notes
207K00000X	Vascular Surgery	Primary specialty performing complex endovascular aortic repairs.
2080P0005X	Interventional Cardiology	Performs endovascular aortic and iliac interventions in some centers.
2084P0800X	Interventional Radiology	Commonly performs endovascular aneurysm repair and provides imaging guidance and radiological interpretation.
207RP1001X	General Surgery (Vascular Surgery)	General surgeons with vascular training who perform endograft procedures.
364S00000X	Diagnostic Radiology	Provides radiological supervision and interpretation during and after the procedure.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I71.4`	Abdominal aortic aneurysm, without rupture	Primary indication for elective aorto–bi–iliac endograft placement to exclude an infrarenal aneurysm and prevent rupture.
`I71.3`	Thoracoabdominal aortic aneurysm, without rupture	Less common for infrarenal endograft; included when extension planning involves thoracoabdominal segments—careful selection required.
`I77.6`	Arterial aneurysm of lower extremity, unspecified	Associated aneurysmal disease of iliac arteries that may necessitate bi-iliac extension of the endograft.
`I70.2`	Atherosclerosis of native arteries of the extremities with intermittent claudication	Peripheral arterial disease that may coexist and require adjunctive iliac angioplasty or stenting during endograft placement.
`I82.4`	Embolism and thrombosis of arteries of lower extremities	Complication risk and possible reason for urgent endovascular intervention if limb ischemia is present.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`34705`	Placement of aorto–bi–iliac endograft for repair of infrarenal aorta/iliac artery (nonrupture)	Primary procedure code describing placement of a Y-shaped endograft extending to both iliac arteries; includes pre-procedure sizing, device selection, nonselective catheterization, angioplasty/stenting, and radiological supervision and interpretation.
`34701`	Endovascular repair, infrarenal aortic/iliac aneurysm, endograft placement, aorto-bi-iliac (if variant exists)	Use for related aortoiliac endograft placements when payer differentiates; verify coding guidance and sequence with `34705`.
`34827`	Endovascular repair, aortoiliac occlusive disease, atherectomy or stent placement (example adjunct)	Performed if adjunctive iliac stenting or angioplasty is required beyond what is included with the endograft per payer policy; document separately.
`35701`	Insertion of intra-arterial stent (not specific)	Used for adjunctive iliac or renal stent placement when not bundled into the primary endograft code per payer rules.
`76775`	Ultrasound, duplex scan of abdominal aorta, intraoperative or perioperative	May be used for intraoperative or immediate postoperative vascular imaging to assess graft placement and limb perfusion.
`76000`	Fluoroscopy (radiologic supervision and interpretation)	Represents fluoroscopic guidance and radiological interpretation components when separately reportable per payer; note that `34705` typically includes radiological supervision and interpretation.

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