Summary & Overview
CPT 35005: Vertebral Artery Repair or Graft Placement
CPT code 35005 represents open surgical access to the vertebral artery for treatment of aneurysm or pseudoaneurysm, with direct vessel repair or graft placement. This code captures complex vascular surgery aimed at addressing both aneurysmal disease and associated occlusive pathology of the vertebral artery. Nationally, accurate use of this code is important for clinical documentation, appropriate site-of-service designation, and alignment with surgical quality and reimbursement frameworks.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for the procedure, typical sites of service, and common billing considerations. The publication outlines benchmarks for coding and utilization where available, summarizes relevant policy and coverage themes for major payers, and provides clinical context to support correct code selection. Data not available in the input is noted where specific payer policies, taxonomy mappings, ICD-10 diagnosis links, or related billing codes would normally be detailed.
This summary is intended for a national audience of billing professionals, vascular surgeons, and policy analysts seeking clear, factual information about the purpose and application of CPT code 35005 without state-specific guidance.
Billing Code Overview
CPT code 35005 describes a surgical vascular procedure in which the provider makes an incision to access the vertebral artery to treat an aneurysm or pseudoaneurysm and any associated occlusive disease. The procedure includes direct repair of the vessel or placement of a graft over the repair site.
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Service type: Open vascular surgical repair of the vertebral artery
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Typical site of service: Inpatient or outpatient hospital operating room, depending on clinical complexity and need for post-operative monitoring
Clinical & Coding Specifications
Clinical Context
A 64-year-old patient presents with symptomatic vertebral artery aneurysm causing recurrent posterior circulation transient ischemic attacks and focal neurologic deficits. Neurovascular imaging (CT angiography and digital subtraction angiography) demonstrates a saccular aneurysm of the extracranial vertebral artery with associated arterial wall degeneration and localized occlusive disease. After multidisciplinary review by neurosurgery and vascular surgery, the patient is scheduled for an open vascular repair. In the operating room under general anesthesia, the surgical team makes an incision over the affected cervical region, dissects to the vertebral artery, advances into the target area, and performs direct arterial repair or interposition graft placement to exclude the aneurysm and restore vessel continuity. Intraoperative neuromonitoring and fluoroscopic guidance may be used. Postoperative care includes ICU monitoring for hemodynamics and neurologic status, antiplatelet therapy as indicated, and vascular imaging prior to discharge to confirm repair integrity.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier (unmodified procedure) | Use when no additional modifier applies and procedure is billed as primary service |
11 |