Summary & Overview
CPT 35001: Carotid or Subclavian Arterial Repair with Graft Placement
CPT code 35001 designates an open neck surgical procedure to directly repair or graft the carotid or subclavian artery for treatment of aneurysm and occlusive disease. Nationally, this code represents high-acuity vascular surgery with implications for inpatient surgical care, perioperative resource utilization, and specialist credentialing. It is relevant to vascular and cardiothoracic surgeons, hospital surgical services, and payers managing high-cost, low-volume procedures.
Key payers referenced include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical description, expected site-of-service patterns, and the payer context that commonly applies to major vascular repairs. The publication covers benchmarking of reimbursement and utilization where available, summarizes relevant policy and coverage considerations that affect surgical authorization and inpatient payment, and outlines the clinical context for coding and billing this procedure.
This analysis is intended for national audiences involved in surgical billing, revenue cycle management, clinical coding, and payer policy. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 35001 describes an open surgical procedure in which the surgeon makes an incision in the neck, advances to the carotid or subclavian artery, and performs direct repair or places a graft to treat an aneurysm or related occlusive disease. This procedure is an arterial repair/reconstruction targeting the carotid or subclavian vessels.
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Service type: Open vascular surgery (arterial repair and graft placement)
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Typical site of service: Hospital operating room or inpatient surgical suite
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with progressive left-sided neck pain, a palpable pulsatile mass in the left neck, and duplex ultrasound demonstrating a saccular aneurysm of the left common carotid artery presents for surgical repair. Preoperative evaluation includes CT angiography confirming a 2.8 cm carotid artery aneurysm with proximal atherosclerotic disease and focal occlusive stenosis. The patient has controlled hypertension and coronary artery disease managed medically. The vascular surgery team schedules an open carotid aneurysm repair under general anesthesia. In the operating room, a transverse cervical incision is made, the carotid sheath is exposed, proximal and distal control established, and the aneurysmal segment is resected. Direct arterial repair is performed with end-to-end anastomosis when feasible; when segmental loss or wall damage prevents tension-free repair, an interposition prosthetic or autogenous graft is placed. Intraoperative duplex or angiography may confirm repair patency. Postoperative management includes ICU observation for neurologic status, blood pressure control, antiplatelet therapy as indicated, and serial neurologic and vascular examinations before discharge.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Normal (primary) procedure | Use when this open carotid repair is the primary procedure performed during the operative session |