CPT 34841 Fenestrated Endograft Reimbursement | OpenPayer

Summary & Overview

CPT 34841: Fenestrated Endograft Repair of Visceral Aorta with Single Visceral Prosthesis

CPT code 34841 represents endovascular repair of the visceral aorta using a fenestrated endograft with placement of a single visceral artery prosthesis under radiological guidance. This complex vascular procedure preserves blood flow to the celiac, superior mesenteric, and renal arteries while excluding aneurysmal or diseased segments of the upper abdominal aorta. Nationally, such procedures are clinically significant due to their role in treating complex aortic pathology and their resource-intensive nature, often performed in tertiary care centers with hybrid operating rooms.

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 and billing context for CPT code 34841, including typical sites of service and service type. The publication summarizes available benchmarks where present, highlights relevant policy considerations that affect coverage and utilization, and provides clinical context to help coding, reimbursement, and administrative teams align documentation with billing requirements. Data not available in the input is noted where applicable, and readers will gain a national perspective useful for payer negotiations, hospital coding workflows, and clinical program planning.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 34841endovascular repairfenestrated endograftvisceral aortavascular surgeryinterventional radiologyaortic aneurysm repairhospital services

Billing Code Overview

CPT code 34841 describes placement, under radiological guidance, of a fenestrated endograft to repair the visceral aorta (the upper abdominal aorta involving the celiac, superior mesenteric, and renal arteries). The procedure includes deployment of a fenestrated aortic stent graft designed with openings to preserve flow to visceral branch vessels and placement of a single visceral artery prosthesis as part of the repair.

Service type: Endovascular aortic repair with fenestrated endograft and visceral artery prosthesis
Typical site of service: Hospital-based vascular interventional suite or hybrid operating room with radiological guidance and endovascular capabilities

Clinical & Coding Specifications

Clinical Context

A 72-year-old male with a symptomatic thoracoabdominal aortic aneurysm involving the visceral segment (celiac axis, superior mesenteric artery, and/or renal arteries) is evaluated for endovascular repair. Imaging with contrast-enhanced CT angiography demonstrates an aneurysmal dilation of the upper abdominal aorta with an inadequate proximal or distal neck for standard endograft fixation and involvement of one or more visceral arteries. The vascular surgery and interventional radiology teams plan a fenestrated endovascular aortic repair (FEVAR) under fluoroscopic and radiologic guidance. Intraoperatively, the operator deploys a fenestrated endograft to preserve flow to the visceral vessels and places a single visceral artery prosthesis (bridging stent) into a target visceral artery to secure blood flow.

Pre-procedure workflow includes multidisciplinary review, informed consent, pre-op imaging review and device planning, anesthesia evaluation (general anesthesia is common), and preparation of endovascular devices. Intra-procedure steps include vascular access (commonly femoral), angiography under radiological guidance, deployment of the fenestrated endograft, cannulation of the target visceral artery through the graft fenestration, deployment of the single visceral artery prosthesis, completion angiography to confirm exclusion of the aneurysm and patency of visceral branches, and hemostasis/closure. Post-procedure workflow includes monitoring in a post-anesthesia care unit or intensive care setting, follow-up imaging (CTA) prior to discharge or at early follow-up, and outpatient surveillance per vascular surgery protocol.

Coding Specifications

Modifier	Description	When to Use

CPT 34848: Fenestrated Endograft Repair of Visceral Aorta

CPT-34843-FENESTRATED-ENDOGRAFT-VISCERAL-AORTA-REPAIR

CPT 34843: Fenestrated Endograft Repair of Visceral Aorta

CPT-34842-FENESTRATED-ENDOGRAFT-VISCERAL-AORTA-REPAIR

CPT 34842: Fenestrated Endograft Repair of Visceral Aorta

CPT-34846-FENESTRATED-VISCERAL-AORTIC-ENDOGRAFT-REPAIR

CPT 34846: Fenestrated Endograft Repair of Visceral Abdominal Aorta

CPT-34844-FENESTRATED-ENDOGRAFT-VISCERAL-AORTA-REPAIR

CPT 34844: Fenestrated Endograft Repair of Visceral Aorta

CPT-34847-FENESTRATED-ENDOGRAFT-VISCERAL-AORTA-REPAIR

CPT 34847: Fenestrated Endograft Repair of Visceral Aorta

CPT-34839-FEVAR-GRAFT-PLANNING-FENESTRATED-ENDOVASCULAR-AORTIC-REPAIR

CPT 34839: Graft Planning for Fenestrated Endovascular Aortic Repair

CPT-34845-FENESTRATED-ENDOGRAFT-VISCERAL-AORTA-REPAIR-SINGLE-VISCERAL-ARTERY

CPT 34845: Fenestrated Endograft Repair of Visceral Aorta with Single Visceral Artery Endoprosthesis

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Taxonomy Code	Specialty	Notes
`2080P0208X`	Vascular Surgery	Primary specialty performing FEVAR and visceral aortic endograft procedures.
`207RG0300X`	Interventional Radiology	Provides radiologic guidance, image interpretation, and endovascular technical expertise.
`207V00000X`	Cardiac Surgery	May be involved when thoracoabdominal aneurysm repair requires cardiac surgical input or hybrid approaches.
`207L00000X`	General Surgery	Vascular-trained general surgeons may perform endovascular aortic repairs in some centers.
`363L00000X`	Critical Care Medicine	Involved in perioperative management for high-risk patients; supportive role rather than primary operator.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I71.6`	Thoracoabdominal aortic aneurysm, ruptured	Ruptured aneurysm of the visceral aortic segment may necessitate emergent endovascular repair with fenestrated endograft.
`I71.4`	Abdominal aortic aneurysm, ruptured	Large aneurysms involving the visceral segment may be coded here when rupture includes upper abdominal aorta.
`I71.3`	Abdominal aortic aneurysm, without rupture	Elective repair indication for aneurysm involving visceral branches.
`I72.3`	Thoracic aortic aneurysm, nonruptured	When thoracoabdominal involvement spans thoracic and visceral segments, this code may be relevant.
`I77.1`	Aneurysm of artery of the lower extremity, nonruptured	Included as a related vascular aneurysm code when multiple aneurysms are present (less specific relevance).

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`34841`	Placement of fenestrated endograft to repair visceral aorta; with placement of a single visceral artery prosthesis	Primary procedure described; fenestrated endograft deployment with one visceral branch stent.
`34701`	Endovascular repair of infrarenal aortic aneurysm using endograft (iliac/femoral access)	May be performed for simpler infrarenal aneurysms; related for comparative coding when visceral segment not involved.
`34833`	Endovascular repair of thoracoabdominal aortic aneurysm with endograft; without fenestrated visceral branch stents	Related when thoracoabdominal repair is performed but without placement of visceral artery prostheses.
`37245`	Transcatheter placement of intravascular stent(s), open or percutaneous, including angioplasty when performed, any vessel(s) of the visceral bed	May be reported for additional or separate visceral artery stenting procedures performed during the same session if payer rules allow.
`36247`	Selective catheter placement, visceral artery, unilateral, with diagnostic angiography	Diagnostic or selective catheterization/angiography of visceral vessels performed pre- or intra-procedurally for planning and guidance.
`76937`	Ultrasound guidance for vascular access (real-time)	Commonly reported when ultrasound is used for femoral arterial access prior to endograft insertion.

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