CPT 34706 Aorto‑bi‑iliac Endograft Reimbursement | OpenPayer

Summary & Overview

CPT 34706: Aorto‑bi‑iliac Endograft Placement for Ruptured Infrarenal Aorta

CPT code 34706 denotes placement of an aorto–bi–iliac endograft — a Y‑shaped endovascular tube graft extending from the infrarenal aorta into both iliac arteries — used to repair a ruptured infrarenal aorta or iliac artery. The code is nationally relevant because it captures a high‑acuity, resource‑intensive endovascular repair that includes device selection, ancillary catheter maneuvers, angioplasty or stenting, endograft extensions to the iliac bifurcation, and full radiological supervision and interpretation. Payers commonly covering analysis for this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will find a concise overview of procedural scope and clinical context, typical sites of service, and which payers are addressed. The publication outlines benchmarking and coverage considerations relevant to emergent complex endovascular aortic repair, highlights common billing modifiers and coding nuances (summary level), and summarizes the clinical indications tied to this code. This material is intended for national audiences including hospital administrators, vascular specialists, coding professionals, and policy analysts who need a clear synopsis of what CPT code 34706 represents and where it applies in clinical and billing workflows. Data not available in the input is noted where applicable in detailed sections.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 34706endovascular aortic repairaorto-bi-iliac endograftvascular surgeryemergency repairendograft placementradiology supervisionhospital service line

Billing Code Overview

CPT code 34706 describes placement of an aorto–bi–iliac endograft, a Y‑shaped endovascular stent graft that extends from the infrarenal aorta into both iliac arteries. The procedure is intended to repair a ruptured infrarenal aorta or iliac artery, and the code encompasses pre‑procedure sizing and device selection, any nonselective catheterization, adjunct angioplasty or stenting, endograft extensions from the renal arteries to the iliac bifurcation, and all radiological supervision and interpretation.

Service type: Endovascular aortic repair (complex; emergent for rupture)

Typical site of service: Hospital operating room or hybrid endovascular suite

Clinical & Coding Specifications

Clinical Context

A 72-year-old male presents to the emergency department with sudden severe abdominal and back pain, hypotension, and a pulsatile abdominal mass. CT angiography demonstrates a ruptured infrarenal abdominal aortic aneurysm with extension into both common iliac arteries. The vascular surgery team is consulted and elects to perform an urgent endovascular repair with placement of an aorto–bi–iliac endograft to exclude the ruptured aneurysm and reestablish distal perfusion.

Pre-procedure workflow includes rapid hemodynamic stabilization, cross-sectional imaging for sizing and planning, informed consent for emergent endovascular aneurysm repair (EVAR), device selection and inventory check, and coordination with anesthesia for general or monitored anesthesia care. In the operating suite or hybrid angiography suite, fluoroscopic guided arterial access (commonly percutaneous common femoral access), angiography for vessel assessment, any required angioplasty or iliac stenting, deployment of the Y-shaped aorto–bi–iliac endograft extending from the infrarenal aorta into both iliac arteries, and completion angiography with radiological supervision and interpretation are performed. Post-procedure care includes intensive monitoring for hemodynamic stability, assessment for endoleak with postoperative imaging, and disposition to the intensive care unit or vascular step-down unit as indicated.

Coding Specifications

Modifier	Description	When to Use
`00`	(Not a CMS standard modifier for claims; present in input list)

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

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

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

CPT-34712-ENDOGRAFT-FIXATION-WITH-IMAGING-GUIDANCE

CPT 34712: Endograft Fixation with Image Guidance

CPT-34716-SUBCLAVIAN-AXILLARY-ARTERY-CONDUIT-CREATION-FOR-ENDOVASCULAR-ACCESS

CPT 34716: Subclavian/Axillary Artery Conduit Creation for Endovascular Access

CPT-34701-INFRARENAL-AORTO-AORTIC-TUBE-ENDOGRAFT-PLACEMENT

CPT 34701: Infrarenal Aorto–Aortic Tube Endograft Placement

CPT-34703-AORTO-UNI-ILIAC-ENDOGRAFT-PLACEMENT

CPT 34703: Aorto–Uni–Iliac Endograft Placement for Infrarenal Aortic or Iliac Repair

CPT-34833-ILIAC-ARTERY-CONDUIT-FOR-ENDOVASCULAR-PROSTHESIS

CPT 34833: Iliac Artery Conduit for Endovascular Prosthesis or Bypass

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

CPT 34718: Branched Iliac Endograft Placement, Unilateral

CPT-34704-AORTO-UNI-ILIAC-ENDOGRAFT-REPAIR-INFRARENAL-ILIAC

CPT 34704: Aorto–Uni–Iliac Endograft Repair of Infrarenal Aorta or Iliac Artery

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

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

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Taxonomy Code	Specialty	Notes
207P00000X	Vascular Surgery	Primary specialty performing endovascular aortic aneurysm repair procedures.
208800000X	General Surgery	General surgeons with vascular training may perform EVAR in some settings.
2080P0206X	Interventional Cardiology	May participate in endovascular aortic interventions in hybrid suites with endovascular expertise.
2084P0800X	Interventional Radiology	Provides fluoroscopic guidance, angiography, and radiological supervision and interpretation.
186L00000X	Anesthesiology	Provides general or monitored anesthesia care required for emergent EVAR.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I71.3`	Abdominal aortic aneurysm, ruptured	Direct indication for emergent aorto–bi–iliac endograft placement to exclude the ruptured aneurysm.
`I71.4`	Abdominal aortic aneurysm, without rupture	Represents underlying aneurysm anatomy that may require repair; relevant for sizing and device planning if rupture risk present.
`I72.3`	Aneurysm of iliac artery	Iliac artery involvement that necessitates extension of endograft into the iliac arteries or iliac repair.
`I74.3`	Embolism and thrombosis of abdominal aorta	May complicate aneurysm pathology or present alongside aortic injury requiring endovascular intervention.
`T79.8`	Other complications of trauma, not elsewhere classified	Used when aneurysm rupture is related to traumatic injury requiring urgent endovascular repair.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`34706`	Placement of an aorto–bi–iliac endograft (Y-shaped) to repair ruptured infrarenal aorta or iliac artery; includes sizing, device selection, angioplasty/stenting, endograft extensions, and radiological supervision	Primary procedure code for emergent aorto–bi–iliac endovascular repair of a ruptured infrarenal aneurysm.
`34802`	Endovascular repair of infrarenal abdominal aortic aneurysm or dissection; with tubular endograft(s), each additional component	Used when additional modular components or extensions beyond the main device are required during the EVAR procedure.
`36245`	Selective catheter placement, arterial system; each first order thoracic, abdominal, pelvic branch, or visceral artery, separate catheterization	May be reported for selective catheterization of branch arteries if clinically required and not included in comprehensive EVAR coding per payer guidelines.
`75710`	Angiography, abdominal aortography including runoff, radiological supervision and interpretation	Pre- or intra-procedural angiography to evaluate aortoiliac anatomy and for completion imaging; radiological interpretation if separately reportable.
`34825`	Endovascular repair of iliac artery aneurysm, bifurcated endograft extension or limb	Used for specific iliac limb extensions or isolated iliac repairs performed in conjunction with the aorto–bi–iliac endograft when payers require separate reporting.

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