Summary & Overview
CPT 35011: Axillary–Brachial Artery Aneurysm Repair
CPT code 35011 denotes open surgical repair of an axillary–brachial artery aneurysm with treatment of associated occlusive disease, using direct arterial repair or placement of a graft. This code captures a high-acuity vascular procedure that can affect perioperative resource use, surgical specialty billing, and inpatient versus outpatient site-of-service decisions. Nationally, accurate coding of such procedures informs reimbursement pathways, quality measurement, and access to specialized vascular surgery services.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, benchmarks for coding and utilization where available, and policy-relevant considerations affecting coverage and site-of-service classification. The publication summarizes how CPT code 35011 is used in clinical documentation, typical care settings, and what implications the code has for hospital and surgical practice workflows.
This analysis provides clinicians, coding professionals, and payers with an overview of the code’s clinical meaning, the likely service environments, and the types of policy and billing topics that influence payment and reporting for axillary–brachial arterial repairs. Data not available in the input is noted as such in relevant sections.
Billing Code Overview
CPT code 35011 describes a surgical procedure in which a provider makes an incision in the arm to access the axillary–brachial artery, treats an aneurysm and related occlusive disease, and then performs direct repair or places a graft over the repair site. This procedure is a vascular surgical intervention aimed at repairing arterial aneurysms and restoring arterial continuity or flow.
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Service type: Open vascular surgery for axillary–brachial artery aneurysm repair and occlusive disease management
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Typical site of service: Hospital operating room or other inpatient/outpatient surgical facility
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with a history of peripheral arterial disease and hypertension presents with a pulsatile mass and pain in the upper arm. Imaging (duplex ultrasound and CT angiography) demonstrates an axillary–brachial artery aneurysm with distal embolic occlusive disease causing ischemic symptoms in the forearm and hand. After preoperative evaluation, the vascular surgeon schedules an open repair. In the operating room under general anesthesia, the surgeon makes an incision in the arm to expose the axillary–brachial artery, controls proximal and distal blood flow, and then performs direct repair or interposition grafting (autogenous vein or prosthetic graft) to exclude the aneurysm and restore distal perfusion. Typical perioperative workflow includes preoperative vascular imaging, anesthesia evaluation, intraoperative vascular control and shunting as needed, graft selection and anastomosis, intraoperative duplex or completion angiography to confirm flow, and postoperative monitoring in a step-down or inpatient setting for limb perfusion, wound care, and anticoagulation management.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Normal, pre-authorized service | Use when the service is the physician's usual performance without complications or unusual services beyond routine. |
22 |