CPT 34712 Endograft Fixation Reimbursement | OpenPayer

Summary & Overview

CPT 34712: Endograft Fixation with Image Guidance

CPT code 34712 describes image-guided placement of fixation devices (anchors, screws, or tacks) to secure a previously implanted endograft in an artery to address graft leak or migration. This targeted endovascular procedure is performed to restore graft stability and prevent complications such as persistent endoleak, continued migration, or compromised perfusion. The code is nationally relevant because it captures advanced interventional management of endograft complications, an increasingly common issue as endovascular repairs expand.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for use of 34712, expected sites of service, and common billing considerations. The publication also outlines benchmark topics and policy-related issues readers can expect: national utilization benchmarks, payer coverage patterns, coding and documentation considerations tied to procedural intent, and recent policy updates affecting endovascular device-related interventions. Clinical context summarizes indications and the role of imaging guidance in achieving device fixation. Where input data are not provided, the report notes "Data not available in the input."

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 34712endograft fixationendovascular repairinterventional radiologyvascular surgeryimage-guided proceduresendoleak managementgraft migration managementprocedure coding

Billing Code Overview

CPT code 34712 describes the use of imaging guidance to place one or more fixation devices (for example, an anchor, screw, or tack) to secure a previously placed endograft in an artery to treat graft leak or migration. Procedure includes placement of fixation devices to stabilize an existing endovascular graft and includes radiological supervision and interpretation as part of the service.

Service type: Endovascular graft fixation under image guidance

Typical site of service: Hospital-based interventional radiology suite or vascular operating room

Clinical & Coding Specifications

Clinical Context

A 72-year-old male with a history of endovascular aneurysm repair (EVAR) for infrarenal abdominal aortic aneurysm presents with progressive sac enlargement on surveillance imaging and symptoms consistent with endograft migration and a type Ia endoleak. The patient is evaluated in the vascular surgery clinic and undergoes pre-procedure CTA to localize the leak and assess access. In the interventional suite or hybrid operating room, under conscious sedation or general anesthesia, the interventionalist uses fluoroscopic imaging to access the arterial system, navigates to the endograft, and deploys one or more fixation devices (anchors, screws, or tacks) to secure the previously placed endograft to the arterial wall. Radiological supervision and interpretation are provided as part of the procedure. Post-procedure, the patient is monitored for access site complications and hemodynamic stability, then discharged same day or after short observation depending on comorbidities and intraoperative events.

Coding Specifications

Modifier	Description	When to Use
`11`	Normal baseline service	Use when the service is the usual, scheduled procedure without unusual circumstances.
`22`	Increased procedural services

CPT 34830: Infrarenal Aortic Tube Prosthesis Repair After Failed EVAR

CPT-34812-FEMORAL-ARTERY-ENDOVASCULAR-PROSTHESIS-ACCESS

CPT 34812: Femoral Artery Access for Endovascular Prosthesis Insertion

CPT-34831-INFRARENAL-AORTIC-REPAIR-AORTO-BI-ILIAC-CONVERSION

CPT 34831: Infrarenal Aortic Repair After Failed Endovascular Repair

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

CPT 34718: Branched Iliac Endograft Placement, Unilateral

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

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

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

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

CPT-34706-AORTO-BI-ILIAC-ENDOGRAFT-FOR-RUPTURED-INFRARENAL-AORTA

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

CPT-34813-FEMORAL-TO-FEMORAL-GRAFT-ADD-ON-ENDOVASCULAR-AORTIC-REPAIR

CPT 34813: Femoral-to-Femoral Graft, Add-On During Endovascular Aortic Repair

CPT-34707-ILIO-ILIAC-ENDOGRAFT-ILIAC-ARTERY-REPAIR

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

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

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

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Taxonomy Code	Specialty	Notes
208100000X	Vascular Surgery	Primary specialty performing endograft fixation and EVAR-related interventions.
207K00000X	Interventional Radiology	Image-guided placement of fixation devices; provides radiological supervision and interpretation.
2080P0206X	Cardiothoracic and Vascular Surgery	Vascular surgeons with combined cardiothoracic expertise performing complex aortic interventions.
363L00000X	Vascular Medicine	Physicians specializing in vascular disease management involved in pre- and post-procedure care.
290800000X	Physician Assistant	Advanced practice clinicians who may assist in perioperative management and intraoperative support.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I71.4`	Abdominal aortic aneurysm, without rupture	Common indication for prior EVAR; post-EVAR complications such as migration or endoleak may necessitate fixation.
`I71.3`	Abdominal aortic aneurysm, ruptured	Relevant when prior aneurysm had rupture; repair and subsequent graft issues can require fixation.
`I72.3`	Aneurysm of artery of lower extremity	Peripheral aneurysms treated with endografts may also require fixation if migration occurs.
`I77.9`	Disorder of artery, unspecified	Used when specific arterial disorder is not otherwise specified but graft instability is present.
`T82.4XXA`	Mechanical complication of vascular prosthetic devices, implants and grafts, initial encounter	Directly describes complications of an endograft such as migration or device failure prompting fixation.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`34712`	Placement of endograft fixation device(s) (e.g., anchor, screw, tack) to secure a previously placed endograft; with imaging guidance; radiological supervision and interpretation included.	Primary procedure code describing image-guided fixation of a migrated or leaking endograft.
`75894`	Transcatheter placement, stent graft, abdominal aorta, deployed within prior endograft (e.g., cuff), includes imaging guidance and radiological supervision and interpretation.	May be performed when an additional stent graft or cuff is needed in conjunction with fixation to treat endoleak or migration.
`34800`	Open revision or repair of previously placed endovascular graft, with or without replacement of graft component(s).	Represents an open surgical alternative when endovascular fixation is not feasible or fails.
`36247`	Selective catheter placement, arterial system; each first order thoracic or abdominal aortography when performed for diagnostic angiography.	Diagnostic angiography code often used for arterial access and diagnostic runs during planning or intra-procedural assessment.
`93975`	Duplex scan of arterial repair/graft; surveillance of endograft patency and detection of endoleak.	Noninvasive surveillance performed before and after fixation to evaluate for endoleak or graft migration.

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