CPT 35002 Open Carotid/Subclavian Repair Reimbursement | OpenPayer

Summary & Overview

CPT 35002: Open Repair of Carotid or Subclavian Artery Aneurysm

CPT code 35002 represents an open vascular surgical repair of a ruptured aneurysm or related occlusive disease involving the carotid or subclavian artery accessed via a neck incision. This is a high-acuity, operative procedure used to control hemorrhage, restore arterial integrity, and reestablish perfusion. Nationally, codes for major vascular repairs are critical for hospital billing, resource allocation, and tracking surgical volume for emergency and elective vascular care. Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, typical sites of service, and which payers are commonly involved in coverage. The publication also outlines commonly reported modifiers and where to look for related documentation and billing considerations. This summary provides an orientation to the procedure and its billing code to support coding accuracy, claims submission, and payer communication. Data not available in the input for items such as associated taxonomies, specific ICD-10 diagnosis mappings, and payer-specific reimbursement benchmarks are noted as unavailable and are not included.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 35002vascular surgerycarotid repairsubclavian repairopen surgical procedureaneurysm repairoperative codinghospital surgery

Billing Code Overview

CPT code 35002 describes an open vascular surgical procedure in which the surgeon makes an incision in the neck to access the carotid or subclavian artery to treat a ruptured aneurysm and associated occlusive disease. The procedure includes advancing to the target arterial site, performing direct repair or placing a graft over the repair site, and then closing the incision.

Service type: Open vascular surgery for repair of carotid or subclavian artery aneurysm/occlusive disease
Typical site of service: Hospital operating room or other inpatient/outpatient surgical setting depending on clinical status and facility capabilities

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult presenting with acute neck pain, pulsatile swelling, focal neurological deficits, or symptoms of cerebral ischemia caused by a ruptured or symptomatic extracranial carotid or subclavian artery aneurysm or by severe occlusive disease requiring open repair. Initial evaluation includes neurovascular examination, urgent CT angiography of the head and neck, and cross-sectional imaging to localize the lesion. The patient is triaged to vascular surgery or a hybrid vascular/cerebrovascular operative suite. Under general anesthesia, the surgeon makes a cervical incision to expose the carotid or subclavian artery, controls proximal and distal flow, performs direct arterial repair or interposition graft placement to exclude the aneurysm or restore lumen patency, achieves hemostasis, and closes the incision. Postoperative care includes neurologic monitoring, blood pressure control, antiplatelet or anticoagulant management per vascular surgery protocols, and vascular imaging surveillance before discharge. Typical inpatient length of stay ranges from 2–7 days depending on neurologic status and comorbidities.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier (default)	Use when no circumstance requires an additional modifier and the procedure is billed as standard.
`11`

CPT 35142: Open Repair of Ruptured Femoral Artery Aneurysm

CPT-35152-POPLITEAL-ARTERY-ANEURYSM-REPAIR-BELOW-KNEE

CPT 35152: Repair of Ruptured Popliteal Artery Aneurysm

CPT-35021-SUBCLAVIAN-INNOMINATE-ARTERY-REPAIR-GRAFT

CPT 35021: Repair/Graft of Subclavian or Innominate Artery Aneurysm

CPT-35131-ILIAC-ARTERY-ANEURYSM-REPAIR-OPEN-ABDOMINAL-RETROPERITONEAL

CPT 35131: Open Repair of Iliac Artery Aneurysm or Pseudoaneurysm

CPT-35102-OPEN-REPAIR-AORTIC-ILIAC-ANEURYSM

CPT 35102: Open Repair of Aortic and Iliac Aneurysm

CPT-35141-FEMORAL-ARTERY-ANEURYSM-REPAIR

CPT 35141: Femoral Artery Aneurysm or Pseudoaneurysm Repair

CPT-35151-POPLITEAL-ARTERY-ANEURYSM-REPAIR

CPT 35151: Popliteal Artery Aneurysm Repair

CPT-35001-CAROTID-SUBCLAVIAN-ARTERIAL-REPAIR-GRAFT-PLACEMENT

CPT 35001: Carotid or Subclavian Arterial Repair with Graft Placement

CPT-35082-OPEN-REPAIR-RUPTURED-ABDOMINAL-AORTIC-ANEURYSM

CPT 35082: Open Repair of Ruptured Abdominal Aortic Aneurysm

CPT-35122-OPEN-VISCERAL-ARTERY-ANEURYSM-REPAIR

CPT 35122: Open Repair of Ruptured Visceral Artery Aneurysm

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Taxonomy Code	Specialty	Notes
208S00000X	Vascular Surgery	Primary specialty performing carotid/subclavian open arterial repair.
207P00000X	Thoracic and Cardiac Surgery	May perform complex subclavian or proximal innominate repairs requiring thoracic exposure.
2080P0004X	General Surgery (Vascular-trained)	General surgeons with vascular focus performing extracranial arterial repairs.
207K00000X	Neurosurgery	In select hybrid cerebrovascular cases involving proximal carotid exposures and intracranial considerations.
363A00000X	Interventional Cardiology	Rarely involved in hybrid cases; usually endovascular adjuncts rather than primary open repair.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I72.8`	Other aneurysm of other specified arteries	Includes aneurysms of extracranial carotid or subclavian arteries requiring surgical repair.
`I72.6`	Arteriovenous aneurysm, other sites	May describe complex aneurysmal disease in neck vasculature when applicable.
`I65.29`	Occlusion and stenosis of unspecified carotid artery	Indicates occlusive disease causing ischemia and necessitating surgical intervention.
`I66.9`	Occlusion and stenosis of cerebral arteries, unspecified	Relevant when extracranial disease causes cerebral ischemic events prompting repair.
`I74.9`	Embolism and thrombosis of unspecified artery	Relevant when embolic occlusion from cervical arterial pathology requires thrombectomy or repair.
`S15.1XXA`	Injury of carotid artery, initial encounter	Traumatic carotid injury leading to open repair in the neck.
`S15.0XXA`	Injury of subclavian artery, initial encounter	Traumatic subclavian artery injury requiring open repair or grafting.
`I70.2`	Atherosclerosis of native arteries of the extremities with intermittent claudication (use cautiously)	May be reported when generalized atherosclerotic disease affects supra-aortic vessels contributing to symptomatic occlusion.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`35721`	Resection, arterial, with interposition graft, neck vessels (e.g., carotid, subclavian)	Describes resection with interposition grafting and may be used when graft placement is performed as primary repair; often an alternative or adjunct code depending on exact technique and CPT definitions.
`35301`	Thrombectomy, arterial, open, neck (including exposure)	Performed when thromboembolic occlusion is present and an open thrombectomy is required in the same operative session.
`33533`	Reconstruction, aortic prosthesis; with replacement of ascending aorta and hemiarch (not in neck)	Included here only as a related major vascular reconstruction code for complex proximal repairs when hybrid thoracic access is required (use depends on anatomic extent).
`36902`	Endovascular repair, percutaneous transluminal angioplasty (PTA) or stent of artery of neck	Performed in hybrid approaches or as follow-up endovascular adjunct to open repair.
`99024`	Postoperative follow-up visit, global period or related care	Used for reporting postoperative follow-up visits during the global surgical period (billing varies by payer).

Note: If precise related codes are required by payer policy, verify coding manuals and local payer guidelines for appropriate selection and bundling rules.

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