CPT 34716 Axillary/Subclavian Conduit Reimbursement | OpenPayer

Summary & Overview

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

CPT code 34716 denotes creation of a conduit in the axillary or subclavian artery via an incision near the clavicle to facilitate insertion of an endovascular prosthesis. The code is reportable in addition to the primary endovascular repair and is relevant to vascular and cardiothoracic surgical teams performing hybrid or complex endovascular procedures. Nationally, this code reflects an important access technique that can affect operative planning, resource use, and coding specificity for advanced endovascular repairs.

Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for arterial conduit creation, implications for coding and billing when reported alongside primary endovascular repair codes, and typical sites of service where the procedure is performed. The publication summarizes common modifiers and related billing considerations, presents benchmark information where available, and outlines the clinical scenarios in which a conduit to the axillary or subclavian artery is used for endovascular device delivery. Data not provided in the input are noted as unavailable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 34716vascular surgeryendovascular accessaxillary arterysubclavian arteryarterial conduithybrid operating roomprocedure coding

Billing Code Overview

CPT code 34716 describes a surgical conduit creation in the subclavian or axillary artery through an incision made above or below the clavicle on the right or left side to permit insertion of an endovascular prosthesis (tube graft). This code is reported in addition to the primary endovascular repair procedure and represents an access conduit creation rather than the definitive endovascular graft placement.

Service type: Open vascular surgical access procedure to create an arterial conduit for endovascular device insertion.
Typical site of service: Hospital operating room or hybrid operating room with vascular surgery and endovascular capabilities.

Clinical & Coding Specifications

Clinical Context

A 72-year-old male with a known thoracic aortic aneurysm involving the proximal descending thoracic aorta and an inadequate femoral/iliac access path is scheduled for endovascular thoracic aortic repair. The vascular surgery team plans a right supraclavicular (or infraclavicular) exposure to create an axillary or subclavian arterial conduit to facilitate delivery of an endovascular stent graft. Under general anesthesia in an operating room or hybrid endovascular suite, the surgeon makes an incision above or below the right or left clavicle, isolates the axillary/subclavian artery, and constructs an arteriotomy conduit (tube graft or Dacron/Polytetrafluoroethylene graft sewn to the artery) to allow insertion and removal of the large-bore delivery system. Following deployment of the endovascular prosthesis (TEVAR), the conduit is removed or ligated and the incision closed. Typical perioperative workflow includes pre-op imaging review (CT angiography), intraoperative fluoroscopy and device deployment, vascular access management through the conduit, hemostasis, and post-anesthesia recovery with vascular and neurologic monitoring. Typical site of service is an inpatient operating room or hybrid endovascular suite due to the complexity and monitoring requirements.

Coding Specifications

Modifier	Description	When to Use
`11`	Normal or routine service	When the procedure is the primary service performed and represents the usual, uncomplicated service.

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

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

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

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

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

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

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

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

CPT 34714: Femoral Artery Conduit for Endovascular Delivery or CPB

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

CPT 34831: Infrarenal Aortic Repair After Failed Endovascular 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-34709-INFRARENAL-AORTIC-ILIAC-EXTENSION-PROSTHESIS-TUBE-GRAFT

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

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 axillary/subclavian conduit creation and endovascular aortic repairs.
207L00000X	Thoracic and Cardiac Surgery	May perform when combined thoracic open or hybrid procedures are required.
2080P0207X	Interventional Cardiology	Participates in endovascular device deployment in hybrid cases.
207RC0000X	Radiology - Diagnostic	Intraoperative imaging support in hybrid suite (fluoroscopy/angiography).
163WL0500X	Anesthesiology	Provides general or regional anesthesia and perioperative management.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I71.1`	Thoracic aortic aneurysm, ruptured	Emergent indication requiring endovascular repair; conduit may be needed for device access.
`I71.2`	Thoracic aortic aneurysm, without rupture	Common elective indication for thoracic endovascular aortic repair (TEVAR) requiring large-bore access.
`I71.3`	Thoracoabdominal aortic aneurysm, ruptured	Complex aneurysm repair where alternative access via axillary/subclavian conduit may be required.
`I71.4`	Thoracoabdominal aortic aneurysm, without rupture	Elective or urgent repair scenarios requiring secure arterial access for stent graft delivery.
`I77.1`	Stricture of artery	Arterial disease limiting femoral/iliac access prompting axillary/subclavian conduit creation.
`I74.3`	Embolism and thrombosis of arteries of lower extremities	Peripheral arterial disease context where alternative central access is needed for aortic intervention.
`Z98.89`	Other specified postprocedural states	Postoperative or prior vascular interventions that influence access strategy and conduit use.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`34701`	Bypass graft, with other than vein; axillary-axillary bypass (with prosthesis)	Alternative open access strategy when endovascular conduit is used for rerouting blood flow or as part of complex access planning.
`34802`	Excision, lesion of subclavian artery (including patch angioplasty); with interposition graft	Open arterial repair that may be performed if conduit creation is converted to formal arterial reconstruction.
`34825`	Bypass graft, with vein; subclavian to carotid (infraclavicular)	Related vascular bypass procedures that may be performed in staged or combined vascular reconstructions.
`33880`	Replacement or repair of thoracic aorta with cardiopulmonary bypass (not used for endovascular)	Represents the open surgical alternative to endovascular repair; relevant when conversion to open repair occurs.
`34716`	Creation of conduit in axillary or subclavian artery for insertion of endovascular prosthesis	Code describing the specific conduit creation; reported in addition to the primary endovascular repair code when conduit is created.
`34832`	Endovascular repair, open or percutaneous, of the subclavian artery including stent; intraoperative imaging	Codes for adjunct endovascular interventions on the same arterial segment during access or device placement.

Note: Report 34716 in addition to the primary endovascular aortic repair code (such as thoracic endovascular aortic repair codes) to reflect the conduit creation performed to facilitate device delivery.

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