Summary & Overview
CPT 34847: Fenestrated Endograft Repair of Visceral Aorta
CPT code 34847 represents a complex endovascular repair of the visceral aorta using a fenestrated endograft with placement of additional visceral artery endoprostheses. This technically demanding procedure addresses aneurysms or other pathologies involving the upper abdominal aorta and the major visceral branches (celiac, superior mesenteric, and renal arteries) and is performed under fluoroscopic guidance in hospital-based vascular or hybrid operating settings. Nationally, the code is important because it captures resource-intensive vascular interventions with implications for facility utilization, inpatient versus outpatient status, and payer policy development.
Key payers in typical analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical service the code represents, typical sites of service, and how the code is used to capture complex fenestrated endograft repairs. The publication outlines common modifiers associated with this service and highlights the kinds of benchmarks and policy topics to review, such as reimbursement status across major payers, bundling and global period considerations, and documentation expectations needed to support medical necessity. Data not available in the input will be identified where applicable in subsequent sections.
Billing Code Overview
CPT code 34847 describes endovascular repair of the visceral aorta using a fenestrated endograft under radiological guidance. The procedure involves placement of a fenestrated (holed) endograft to repair the upper abdominal aorta involving the celiac, superior mesenteric, and renal arteries, with placement of one-piece or multi-piece components in the infrarenal aorta and three additional visceral artery endoprostheses.
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Service type: Complex endovascular aortic repair with fenestrated endograft and visceral artery stenting
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Typical site of service: Hospital-based vascular/interventional radiology or hybrid operating room with fluoroscopic guidance
Clinical & Coding Specifications
Clinical Context
A 72‑year‑old male with a history of hypertension, peripheral arterial disease, and a 5.5 cm juxtarenal abdominal aortic aneurysm presenting for endovascular repair. Preoperative CTA demonstrates aneurysmal dilation involving the visceral aorta with involvement of the origins of the celiac artery, superior mesenteric artery, and both renal arteries, requiring a fenestrated endograft. The interventional vascular surgeon performs the procedure in a hospital hybrid operating room under fluoroscopic and radiological guidance. General anesthesia is provided by the anesthesia team. Vascular access is achieved via bilateral common femoral artery cutdowns or percutaneous access. A fenestrated endograft is deployed in the visceral aorta and an infrarenal component is placed; three additional visceral artery endoprostheses (stents) are delivered to preserve flow to the celiac, superior mesenteric, and a renal artery. Completion angiography confirms exclusion of the aneurysm sac and patency of branch vessels. The patient is monitored in a post‑anesthesia care unit and typically admitted to a monitored bed; expected postoperative workflow includes vascular laboratory duplex surveillance and CTA follow‑up at 1 month and annually thereafter.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier; standard reporting | Use when no modifier applies to the service. |