Summary & Overview
CPT 34846: Fenestrated Endograft Repair of Visceral Abdominal Aorta
CPT code 34846 represents an endovascular repair of the visceral abdominal aorta using a fenestrated endograft and additional visceral artery endoprostheses. This complex, image-guided procedure addresses aneurysms or other pathologies affecting the aortic segment that gives rise to the celiac, superior mesenteric, and renal arteries. The code captures placement of a fenestrated main endograft with deployment of an infrarenal component and two visceral artery stents.
This code matters nationally because it reflects advanced endovascular aortic therapy with higher resource use, specialized devices, and multidisciplinary care in hospital interventional suites. Key payers discussed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Payer behavior on coverage and payment influences access to fenestrated endograft repair and device utilization across the United States.
Readers will learn the clinical scope of the code, typical care setting and service type, and the elements that make this procedure resource-intensive. The publication provides benchmarks and payer-focused context, highlights relevant billing considerations, and summarizes clinical indications and procedural components tied to CPT code 34846. Data not available in the input will be noted where applicable.
Billing Code Overview
CPT code 34846 describes endovascular repair of the visceral aorta using a fenestrated endograft. Under radiological guidance, the provider deploys a fenestrated endograft (with fenestrations/holes) to reconstruct the visceral segment of the abdominal aorta that includes the celiac, superior mesenteric, and renal arteries. The procedure includes placement of an endograft in the infrarenal aorta and placement of two additional visceral artery endoprostheses.
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Service type: Endovascular aortic repair with fenestrated endograft and visceral artery stenting
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Typical site of service: Hospital-based interventional radiology or hybrid operating room in an acute care hospital setting
Clinical & Coding Specifications
Clinical Context
A 72-year-old male with a symptomatic pararenal abdominal aortic aneurysm involving the visceral segment (celiac, superior mesenteric, and renal arteries) presents with increasing abdominal/back pain and progressive enlargement on surveillance imaging. The vascular surgery and interventional radiology teams schedule an endovascular repair with a fenestrated endograft to exclude the aneurysm while preserving flow to visceral branches. Under general endotracheal anesthesia in a hybrid operating suite, the provider obtains femoral arterial access, performs intraprocedural angiography and cone-beam CT for device planning and orientation, and deploys a fenestrated aortic endograft in the visceral aorta and an infrarenal component as required. Two additional visceral artery endoprostheses are advanced through fenestrations and deployed to seal and maintain perfusion of targeted visceral arteries. Hemostasis is achieved at access sites and the patient is recovered in a monitored acute care setting.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
62 | Two surgeons | Use when two surgeons operate together, each performing distinct portions of a complex fenestrated endograft procedure. |
63 | Procedure performed on infants less than 4 kg |