Summary & Overview
CPT 34830: Infrarenal Aortic Tube Prosthesis Repair After Failed EVAR
Headline: CPT code 34830: Open Infrarenal Aortic Tube Graft After Failed Endovascular Repair
Lead: CPT code 34830 identifies an open surgical conversion procedure in which a surgeon uses an abdominal or retroperitoneal approach to repair an infrarenal aortic aneurysm or dissection with a tube prosthesis following an unsuccessful endovascular repair. The code captures both definitive vascular reconstruction and repair of trauma related to the failed endovascular attempt.
Why it matters: This code is clinically significant because it denotes a high-acuity, resource-intensive operation often performed emergently and typically in the inpatient operating room. As endovascular aneurysm repair (EVAR) use grows, recognition of conversion-to-open procedures and accurate coding for subsequent complex repairs is important for clinical documentation, hospital resource planning, and payer adjudication.
Key payers covered: Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
What readers will learn: The report explains the clinical scenario represented by CPT code 34830, typical care setting and service type, and common coding considerations. It summarizes national implications for utilization and reimbursement context and highlights documentation points relevant to distinguishing this conversion procedure from primary open repair. Data not available in the input for payer-specific rates, associated taxonomies, or ICD-10 diagnosis mappings.
Billing Code Overview
CPT code 34830 describes open surgical repair of an aneurysm or dissection of the infrarenal aorta using a tube prosthesis after an unsuccessful endovascular repair. The procedure includes use of an abdominal or retroperitoneal incision and repair of any associated trauma resulting from the prior unsuccessful endovascular attempt.
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Service type: Open vascular surgical repair (conversion from endovascular repair)
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Typical site of service: Inpatient operating room, typically performed in a hospital setting under general anesthesia
Clinical & Coding Specifications
Clinical Context
A 72-year-old male with known infrarenal abdominal aortic aneurysm (AAA) undergoes a planned endovascular aneurysm repair (EVAR). During the EVAR, the endograft fails to seal or migrates, causing persistent endoleak and iatrogenic aortic injury with hemodynamic instability. The vascular surgery team converts to open repair via an abdominal or retroperitoneal approach. Through a midline laparotomy or left retroperitoneal incision, the surgeon exposes the infrarenal aorta, controls proximal and distal vessels, excises or excludes the damaged segment, and implants a synthetic tube prosthesis to repair the aneurysm or dissection. Concurrently, the team addresses associated trauma from the unsuccessful endovascular attempt (e.g., arterial perforation, retroperitoneal hematoma, graft fragment retrieval, or arterial thrombosis). Intraoperative monitoring includes arterial line, central venous access, and cell-salvage for blood management. Postoperative care involves intensive monitoring for graft patency, renal perfusion, wound complications, and surveillance imaging before discharge. Typical site of service: hospital operating room with postoperative care in an intensive care unit or step-down unit. Service type: open vascular surgical procedure (emergency or urgent conversion from endovascular repair).
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Procedure code with unspecified modifier (placeholder) | Rarely used; not a standard CMS modifier for billing — use only per specific payer instruction. |