CPT 34715 Axillary/Subclavian Access Reimbursement | OpenPayer

Summary & Overview

CPT 34715: Axillary/Subclavian Access for Endovascular Prosthesis Insertion

CPT code 34715 denotes the surgical incision and exposure of the axillary or subclavian artery, above or below the clavicle, specifically for insertion of an endovascular prosthesis (tube graft). Reported adjunctively to the primary endovascular repair code, this procedure code captures the additional operative work associated with vascular access when an incision is required. Nationally, accurate reporting of access-related CPT codes affects procedural bundling, payment stratification, and quality measurement for complex endovascular repairs.

Key payers in typical analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find context on clinical indications for access incisions, expected sites of service (operating room or vascular procedure suite), common billing considerations, and typical modifiers used with access procedures. The publication also outlines benchmarks and policy updates relevant to surgical vascular access coding and the interaction between primary endovascular procedure codes and adjunctive access codes.

This summary provides clinicians, coding professionals, and policy analysts a concise reference to understand when and why 34715 is reported, how it relates to endovascular repair workflow, and which national payers commonly cover such services. Data not available in the input will be identified in the detailed sections of the full publication.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 34715endovascular accessvascular surgeryoperating roomprocedure codingsurgical incisiontube graftvascular access

Billing Code Overview

CPT code 34715 describes an incision above or below the clavicle to access the axillary or subclavian artery for insertion of an endovascular prosthesis (tube graft). This code is reported in addition to the primary endovascular repair procedure and represents the vascular access incision required to deliver the graft.

Service type: Surgical vascular access for endovascular prosthesis insertion
Typical site of service: Operating room or vascular procedure suite, with incision in the infraclavicular or supraclavicular region extending to the axillary or subclavian artery

Clinical & Coding Specifications

Clinical Context

A 72-year-old male with a history of hypertension and peripheral artery disease presents with a symptomatic thoracic aortic aneurysm requiring endovascular repair. The vascular surgery team schedules a thoracic endovascular aortic repair (TEVAR). During the endovascular procedure, the surgeon requires an additional incision below the right clavicle down to the axillary/subclavian artery to gain direct access for insertion of the endovascular prosthesis (tube graft). The workflow includes preoperative imaging review (CT angiography), intraoperative vascular access via the subclavian or axillary artery through a supraclavicular or infraclavicular incision, deployment of the endovascular graft, confirmation angiography, and closure of the access site. Postoperative care includes vascular monitoring, wound checks at the clavicular incision, and imaging follow-up to assess graft position and exclude endoleak.

Coding Specifications

Modifier	Description	When to Use
`11`	Normal or routine service	Use when the procedure is the primary service performed during the encounter.
`22`	Increased procedural services	Use when work required is substantially greater than typical for this procedure (requires documentation).

CPT 34701: Infrarenal Aorto–Aortic Tube Endograft Placement

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

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

CPT-34711-INFRARENAL-AORTIC-ILIAC-EXTENSION-PROSTHESIS-ADD-ON

CPT 34711: Extension Prosthesis for Infrarenal Aortic or Iliac Vessel, Add-on

CPT-34705-AORTO-BI-ILIAC-ENDOGRAFT-PLACEMENT-INFRARENAL-REPAIR

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

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

CPT 34714: Femoral Artery Conduit for Endovascular Delivery or CPB

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

CPT 34833: Iliac Artery Conduit for Endovascular Prosthesis or Bypass

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

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

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

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

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

CPT 34812: Femoral Artery Access for Endovascular Prosthesis Insertion

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

CPT 34712: Endograft Fixation with Image Guidance

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Taxonomy Code	Specialty	Notes
207RG0100X	Vascular Surgery	Primary specialty performing open and endovascular aortic access and repair.
2080P0208X	Interventional Cardiology	May perform endovascular aortic procedures in some centers.
207L00000X	General Surgery	Surgeons with vascular interest who may perform axillary/subclavian access.
2086S0121X	Cardiothoracic Surgery	May be involved for thoracic aortic repairs and complex exposures.
363L00000X	Radiology/Interventional Radiology	Provides image-guided endovascular access and graft deployment.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I71.2`	Thoracic aortic aneurysm, without rupture	Common indication for thoracic endovascular aortic repair requiring graft insertion via axillary/subclavian access when femoral access is unsuitable.
`I71.3`	Thoracic aortic aneurysm, ruptured	Emergent indication where alternative access such as axillary/subclavian may be required for rapid endovascular control.
`I71.4`	Abdominal aortic aneurysm, ruptured	Large or complex aneurysms may require alternative access for endograft insertion.
`I71.9`	Aortic aneurysm, unspecified site, without rupture	General aortic aneurysm diagnosis that may necessitate endovascular repair with nonfemoral access.
`I77.1`	Stricture of artery	Severe peripheral access disease or iliofemoral occlusive disease may prompt use of axillary/subclavian access for device delivery.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`34715`	Incision below or above the clavicle to the axillary or subclavian artery for insertion of an endovascular prosthesis (tube graft) — reported in addition to primary endovascular repair procedure	This is the access incision code that is appended to the primary endovascular repair code when subclavian/axillary surgical exposure is used for graft insertion.
`34701`	Endovascular repair of infrarenal abdominal aorta or iliac artery with prosthesis, insertion via femoral artery (example)	Common primary endovascular repair code for abdominal aortic aneurysm; `34715` would be reported in addition if axillary/subclavian access is used instead of femoral.
`33880`	Thoracic aortic stent graft implantation, percutaneous or open; first endograft component	Often reported for thoracic endovascular aortic repair (TEVAR); `34715` is reported in addition when axillary/subclavian artery exposure is performed for graft insertion.
`34900`	Surgical exposure of subclavian artery	Related exposure codes that may be performed in complex open or hybrid procedures when additional exposure is required alongside endovascular access.
`35700`	Exposure of axillary artery	May be reported when formal axillary artery exposure is performed as part of gaining access for device insertion in hybrid or open-assisted endovascular procedures.

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