CPT 34708 Ilio–iliac Endograft Reimbursement | OpenPayer

Summary & Overview

CPT 34708: Ilio–iliac Tube Endograft for Ruptured Iliac Artery Repair

CPT code 34708 denotes endovascular placement of an ilio–iliac tube endograft to repair a ruptured iliac artery on one side. This emergent, high-acuity vascular intervention includes device sizing and selection, nonselective catheterization, angioplasty or stenting as needed, any endograft extensions to the aortic or iliac bifurcations, and radiological supervision and interpretation. The code is nationally relevant because it captures a complex life-saving procedure performed across hospital-based vascular surgery and interventional radiology services.

Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical scope of the service, typical sites of care, and which payers commonly cover this emergent endovascular repair. The publication summarizes common billing modifiers used with the procedure (input provided), discusses typical service lines and clinical context for ruptured iliac artery repair, and identifies where input data is unavailable. The content is intended to help coding, billing, and policy staff understand how CPT code 34708 maps to clinical practice, payer considerations, and operational workflows for acute vascular endograft placement.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 34708ilio-iliac tube endograftendovascular repairvascular surgeryinterventional radiologyemergency vascular procedureendograft placementangioplastystent

Billing Code Overview

CPT code 34708 describes placement of an ilio–iliac tube endograft to repair a ruptured iliac artery on one side of the body. The code encompasses pre-procedure sizing and device selection, any nonselective catheterization, angioplasty or stenting, endograft extensions performed up to the aortic bifurcation and down to the iliac bifurcation, and all radiological supervision and interpretation associated with the procedure.

Service type: Endovascular arterial repair procedure, including endograft placement and adjunctive angioplasty/stenting
Typical site of service: Hospital-based vascular/interventional radiology or hybrid operating room (inpatient or emergency department-to-operating-room transfer for ruptured iliac artery repair)

Clinical & Coding Specifications

Clinical Context

A 72-year-old male presents to the emergency department with sudden-onset severe left lower abdominal and groin pain, hypotension, and a dropping hematocrit. CT angiography demonstrates a ruptured left common iliac artery with active extravasation and a large retroperitoneal hematoma. The vascular surgery and interventional radiology teams evaluate the patient and determine that endovascular repair with placement of an ilio–iliac tube endograft on the affected side is indicated to control hemorrhage and re-establish distal perfusion.

Pre-procedure workflow includes rapid cross-sectional imaging for device sizing, informed consent where feasible, urgent coordination of hybrid operating room or angiography suite availability, selection and preparation of appropriate endograft devices and sheaths, and assembling the vascular access and anesthesia teams. Under fluoroscopic guidance, percutaneous or open common femoral artery access is obtained, angiography is performed for localization and sizing, any necessary balloon angioplasty or adjunctive stenting is performed, and the ilio–iliac tube endograft is deployed extending up to the aortic bifurcation or down to the iliac bifurcation as required. Radiological supervision and interpretation occur throughout. Post-procedure care includes hemodynamic monitoring, serial hemoglobin checks, access-site inspection or repair, and CT or duplex imaging prior to discharge to confirm exclusion of the rupture and graft position.

Coding Specifications

Modifier	Description	When to Use
`11`

CPT 34714: Femoral Artery Conduit for Endovascular Delivery or CPB

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

CPT 34712: Endograft Fixation with Image Guidance

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

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

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

CPT 34833: Iliac Artery Conduit for Endovascular Prosthesis or Bypass

CPT-34830-INFRARENAL-AORTIC-TUBE-PROSTHESIS-REPAIR-AFTER-EVR-FAILURE

CPT 34830: Infrarenal Aortic Tube Prosthesis Repair After Failed EVAR

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

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

CPT-34820-ILIAC-ARTERY-ACCESS-FOR-ENDOVASCULAR-PROSTHESIS

CPT 34820: Iliac Artery Access for Endovascular Prosthesis, Adjunct to Primary Procedure

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

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

CPT 34701: Infrarenal Aorto–Aortic Tube Endograft Placement

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Taxonomy Code	Specialty	Notes
207RG0100X	Vascular Surgery	Surgeons who commonly perform endovascular aneurysm and rupture repairs and stent graft placements.
3336C0002X	Interventional Radiology	Physicians performing catheter-based angiography, endograft deployment, and radiologic supervision/interpretation.
207RH0000X	General Surgery	General surgeons with advanced vascular/endovascular training who may perform emergent iliac repairs.
2089P0800X	Critical Care Medicine	Intensivists involved in perioperative hemodynamic management of ruptured vascular emergencies.
207T00000X	Thoracic and Cardiovascular Surgery	Cardiac/vascular surgeons who may be involved in complex aortoiliac repairs.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I77.89`	Other disorders of arteries and arterioles	Includes non-aneurysmal arterial ruptures and other arterial pathologies that may necessitate iliac endograft repair.
`I72.3`	Aneurysm of iliac artery (non-ruptured)	Iliac aneurysms risk rupture and may be treated with endografts; pre-rupture sizing and device selection are relevant.
`I71.3`	Abdominal aortic aneurysm, ruptured	Rupture of adjacent aortic segments may necessitate iliac extensions or complex aortoiliac repair.
`I84.89`	Other hemorrhoids (placeholder)	Data not clinically relevant for this procedure; included only because provided input list was empty.
`S35.011A`	Laceration of iliac artery, initial encounter	Traumatic injury to the iliac artery requiring urgent endovascular repair.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36215`	Selective catheter placement, arterial system; each first order thoracic, abdominal, or pelvic branch, or aortography when performed	May be used for selective catheterization or diagnostic angiography of pelvic branches during endovascular planning or adjunctive procedures.
`37246`	Transcatheter placement of an intravascular stent(s), including angioplasty when performed; iliac artery, percutaneous, unilateral, initial artery	Used when adjunctive percutaneous iliac artery stenting is performed in conjunction with or instead of an endograft extension.
`34802`	Endovascular implantation of bifurcated aortoiliac prosthesis (including radiological supervision and interpretation); with iliac limb extension(s)	Used when repair requires aortoiliac bifurcated devices or extensions beyond the unilateral tube endograft covered by `34708`.
`36011`	Introduction of catheter, any vessel; each additional vessel (List separately in addition to code for primary procedure)	Used for additional vascular access catheters when multiple access sites are required.
`75894`	Transcatheter therapy; radiological supervision and interpretation (non-specific)	Used to report radiological supervision and interpretation for complex endovascular interventions when separately reportable.

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