Summary & Overview
CPT 35045: Radial or Ulnar Artery Repair, Forearm
CPT code 35045 denotes open surgical repair of an aneurysm or pseudoaneurysm of the radial or ulnar artery via a forearm incision, with direct arterial repair or graft placement. This code is clinically important because it captures a targeted vascular reconstruction procedure for upper-extremity arterial pathology that can affect limb perfusion and limb-sparing decision-making. Accurate coding supports appropriate payment for vascular surgeons and surgical teams and informs utilization tracking for peripheral vascular repair.
Key payers in this national overview include 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 payer populations are addressed. The publication summarizes expected service line placement, common procedural modifiers where applicable, and comparisons to related vascular repair services when available.
This report helps billing managers, vascular surgeons, and policy analysts understand where CPT code 35045 fits within vascular surgery coding, what clinical situations trigger its use, and which payers underlie national coverage and reimbursement patterns. Data not available in the input is noted where relevant, and the focus remains on clinical and billing context rather than individualized clinical guidance.
Billing Code Overview
CPT code 35045 describes a surgical procedure in which an incision is made in the forearm to access an aneurysm or pseudoaneurysm of the radial or ulnar artery. The provider performs direct repair of the arterial wall or places a graft at the repair site.
Service type: Surgical vascular repair of peripheral upper extremity artery
Typical site of service: Operating room or procedure suite in an inpatient or outpatient surgical setting (upper extremity/forearm)
Clinical & Coding Specifications
Clinical Context
A 58-year-old male with a history of repetitive forearm trauma from occupational machinery presents with a pulsatile, painful mass over the radial artery at the wrist with overlying skin erythema. Duplex ultrasound confirms a 1.5 cm radial artery pseudoaneurysm. The vascular surgery team schedules an open repair with incision over the radial artery, evacuation of the pseudoaneurysm sac, and primary arterial repair or interposition grafting as indicated. The patient is admitted through the outpatient surgical pathway, receives preoperative antibiotics and local or general anesthesia depending on comorbidities, and is observed postoperatively for limb perfusion, wound complications, and nerve function. Typical workflow elements include preoperative imaging (duplex or CT angiography if complex), informed consent documenting risks (bleeding, infection, nerve injury, ischemia), intraoperative arterial control and repair, hemostasis verification, and postoperative vascular exams with instructions for wound care and activity restrictions. Typical sites of service are an ambulatory surgery center or hospital operating room. Typical clinical providers are vascular surgeons or general surgeons with vascular expertise, often working alongside anesthesiology and perioperative nursing teams.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
50 | Bilateral procedure | When identical radial/ulnar artery repairs are performed on both extremities during the same operative session |