Summary & Overview
CPT 34844: Fenestrated Endograft Repair of Visceral Aorta
CPT code 34844 represents endovascular repair of the visceral aorta using a fenestrated endograft with placement of additional visceral artery endoprostheses. This complex, image-guided procedure preserves flow to the celiac, superior mesenteric, and renal arteries while excluding aneurysmal or diseased aortic segments. Nationally, the code captures high-acuity vascular interventions that carry significant resource use, specialized device costs, and multidisciplinary care pathways.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical description, typical sites of service, and the service type represented by the code. The publication provides benchmarking context for utilization and reimbursement (where available), summarizes relevant policy considerations for coverage and prior authorization, and clarifies clinical context for coders and administrators managing complex aortic endovascular procedures. Data not available in the input is noted where applicable, and the material is intended for national audiences involved in billing, revenue management, and clinical operations for vascular and endovascular services.
Billing Code Overview
CPT code 34844 describes the endovascular placement of a fenestrated endograft to repair the visceral aorta, the segment of the upper abdominal aorta that gives rise to the celiac, superior mesenteric, and renal arteries. The procedure includes placement of the fenestrated main endograft and additional visceral artery endoprostheses to maintain perfusion to target visceral branches.
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Service type: Endovascular aortic repair with fenestrated endograft and visceral branch stenting
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Typical site of service: Hospital inpatient operating room or hybrid endovascular suite
Clinical & Coding Specifications
Clinical Context
A 72-year-old male with a 6.5 cm juxtarenal abdominal aortic aneurysm involving the visceral segment (celiac, superior mesenteric, and both renal arteries) presents for endovascular repair. He has hypertension and chronic obstructive pulmonary disease, increasing open repair risk. After preoperative CT angiography and multidisciplinary planning, the vascular surgery and interventional radiology teams perform an endovascular fenestrated aortic endograft placement under fluoroscopic radiological guidance to seal the aneurysm proximally while maintaining perfusion to visceral branches. The provider deploys a fenestrated endograft to the visceral aorta and places four additional visceral artery endoprostheses (branch stents) into the celiac, superior mesenteric, and both renal arteries through femoral arterial access. Completion angiography confirms seal of the aneurysm sac and patency of visceral branches. Post-procedure the patient is monitored in a vascular step-down unit, with follow-up CTA planned at 1 month and ongoing surveillance for endoleak or graft migration.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
62 | Two surgeons | Use when two surgeons of different specialties work together as primary surgeons during the procedure. |
66 |