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    OpenPayerBilling CodesDirect Repair of Aneurysm or Excision (Partial or Total) and Graft Insertion for Aneurysm, Pseudoaneurysm, Ruptured Aneurysm, and Associated Occlusive Disease ProceduresCPT cpt-35082-open-repair-ruptured-abdominal-aortic-aneurysm
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    CPT 35082: Open Repair of Ruptured Abdominal Aortic Aneurysm

    Medicare pays $1953 on average nationally for this procedure.

    CPT code 35082 describes an open abdominal surgical procedure in which the surgeon makes an incision to access a ruptured abdominal aortic aneurysm and performs direct repair or places a graft at the rupture site; service type: open vascular surgery; typical site of service: inpatient operating room or emergency surgical setting for abdominal aortic repair.

    For related coverage guidance, see recent payer policy updates: Automated Ambulatory Blood Pressure Monitoring for Diagnosis of Hypertension in Patients with Elevated Office Blood Pressure, Cardiology - Ivabradine, Cardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA).

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an older adult, often male, presenting to the emergency department with sudden-onset severe abdominal and back pain, hypotension, and a pulsatile abdominal mass consistent with a ruptured abdominal aortic aneurysm (AAA). Rapid triage includes focused history, physical exam, emergent computed tomography angiography (CTA) of the abdomen if hemodynamically stable, point-of-care ultrasound when unstable, and immediate surgical consultation. The vascular surgery or trauma surgery team prepares for open abdominal exploration. In the operating room under general anesthesia, a midline laparotomy is performed to access the ruptured abdominal aorta. Hemorrhage control is achieved with direct vessel clamping, proximal and distal control, and either primary repair or insertion of a synthetic graft (tube or bifurcated graft) depending on aneurysm anatomy and involvement of iliac vessels. Intraoperative blood transfusion, hemodynamic support, and possible concurrent procedures (e.g., bowel assessment, renal protection measures) are common. Postoperatively the patient is managed in an intensive care unit for hemodynamic stabilization, ventilator support as needed, and monitoring for complications such as renal failure, limb ischemia, graft infection, or rebleeding. Typical coders will assign 35082 for open repair of ruptured abdominal aortic aneurysm when performed via abdominal incision with direct repair or graft placement. Common payors for claims submissions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    34800Exploratory thoracotomy with cardiopulmonary bypass, not otherwise specifiedMay be performed when thoracoabdominal extension or control is required (rare adjunct).
    35800Aortic thrombectomy; with or without embolectomy of iliac or femoral arteriesUsed when thromboembolic complications of aneurysm require removal during the repair.
    36245Selective catheter placement, visceral branch, aortaUsed preoperatively or intraoperatively for angiographic assessment or embolization of bleeding branches when endovascular adjuncts are needed.
    36011Introduction of non-tunneled centrally inserted central venous catheter, age 5 years or olderCommonly placed for massive transfusion and central venous access during resuscitation.
    36415Collection of venous blood by venipunctureRoutine perioperative laboratory monitoring (basic service often bundled).

    Related Modifiers

    10 rows

    ModifierDescriptionWhen to Use
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207P00000X
    2086S0122X
    208000000X
    1835G0000X
    208C00000X
    207RE0101X
    225CX0006X
    207SG0207X

    Related Payer Policy Updates

    Specialty: Cardiology1 / 3

    10 rows

    PolicyPayerEffective Date
    Automated Ambulatory Blood Pressure Monitoring for Diagnosis of Hypertension in Patients with Elevated Office Blood PressureBluecross Idaho2026-11-01
    Cardiology - IvabradineCigna2026-10-15
    Cardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA)univerahealthcare2026-10-15
    Percutaneous Ventricular Assist DeviceUnitedHealthcare2026-10-01
    Cardiovascular Disease Risk AssessmentOscar Health2026-10-01
    Biomarkers for Myocardial Infarction and Chronic Heart FailureOscar Health2026-10-01
    Multiple Procedure Payment Reduction for Diagnostic Cardiovascular ProceduresBlue Cross Blue Shield - Maine2026-10-01
    Left Atrial Appendage Closure Devicesexcellus_health_plan_inc2026-09-17
    Left Atrial Appendage Closure Devicesuniverahealthcare2026-09-17
    Cardiac Omnibus CodesCigna2026-09-15

    Related Codes

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

    CPT 35001: Carotid or Subclavian Artery Repair with Graft

    CPT-35002-CAROTID-SUBCLAVIAN-ARTERY-OPEN-REPAIR-ANEURYSM

    CPT 35002: Open Repair/Graft of Carotid or Subclavian Artery

    CPT-35005-VERTEBRAL-ARTERY-REPAIR-OR-GRAFT-PLACEMENT

    CPT 35005: Open Repair of Vertebral Artery Aneurysm or Pseudoaneurysm

    CPT-35011-AXILLARY-BRACHIAL-ARTERY-ANEURYSM-REPAIR

    CPT 35011: Axillary–Brachial Artery Repair or Graft Placement

    CPT-35013-AXILLARY-BRACHIAL-ARTERY-REPAIR-GRAFT

    CPT 35013: Axillary–Brachial Artery Repair or Graft

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

    CPT 35021: Repair of Subclavian or Innominate Artery Aneurysm

    CPT-35022-SUBCLAVIAN-INNOMINATE-ARTERY-OPEN-REPAIR-GRAFT

    CPT 35022: Open Repair of Ruptured Subclavian or Innominate Artery

    CPT-35045-RADIAL-ULNAR-ARTERY-REPAIR-FOREARM

    CPT 35045: Repair of Radial or Ulnar Artery Aneurysm or Pseudoaneurysm

    CPT-35081-OPEN-ABDOMINAL-AORTIC-ANEURYSM-REPAIR

    CPT 35081: Open Repair of Abdominal Aortic Aneurysm

    CPT-35091-OPEN-ABDOMINAL-AORTIC-ANEURYSM-REPAIR-OR-GRAFT

    CPT 35091: Open Abdominal Aortic Aneurysm Repair

    Showing 1–10 of 23

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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