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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-35091-open-abdominal-aortic-aneurysm-repair-or-graft
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    CPT 35091: Open Abdominal Aortic Aneurysm Repair

    Medicare pays $1600 on average nationally for this procedure.

    CPT code 35091 describes an open abdominal procedure in which the surgeon makes an abdominal incision to expose an aneurysm or pseudoaneurysm of the abdominal aorta or visceral vessels and performs direct repair or places a graft at the repair site; service type: open vascular surgical repair, typical site of service: operating room in an inpatient or outpatient hospital surgical setting.

    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 a 68-year-old male with a known infrarenal abdominal aortic aneurysm (AAA) presenting with increasing abdominal/back pain and aortic diameter enlargement on surveillance imaging. After cross-sectional imaging (CT angiography) confirms an enlarging or symptomatic aneurysm not amenable to endovascular repair, the vascular surgery team schedules an open abdominal aortic aneurysm repair. The patient is admitted to the hospital preoperatively for optimization of comorbidities (cardiac clearance, medication management, blood typing and crossmatch). In the operating room under general anesthesia, the surgeon makes an abdominal incision, gains proximal and distal control of the aorta and involved visceral vessels, performs direct repair or places a prosthetic graft, ensures hemostasis, and closes the abdomen. Postoperative care includes ICU monitoring for hemodynamics, renal function, and limb perfusion, pain control, DVT prophylaxis, and wound care. Discharge planning includes follow-up imaging and outpatient vascular surgery clinic visits.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    35091Open repair of abdominal aortic aneurysm or pseudoaneurysm with direct repair or graft placementPrimary procedure description for open abdominal aortic and visceral vessel aneurysm repair.
    34900Direct repair of aneurysm, abdominal aorta (without graft)Alternative technique when direct suture repair is feasible rather than graft placement.
    34802Repair of ruptured abdominal aorta; initial procedure, direct suture repairUsed when emergent repair for rupture is performed and documents the specific rupture repair.
    35631Replacement, abdominal aorta; with synthetic graft (infrarenal)Often reported for prosthetic graft placement in open aortic reconstruction (surgeon documents graft type and anatomic extent).
    36147Insertion of catheter, arteriovenous, for diagnostic angiography (aorta)Diagnostic aortography performed intraoperatively or preoperatively to define anatomy and guide repair.

    Related Modifiers

    12 rows

    ModifierDescriptionWhen to Use
    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…
    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…
    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…
    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…
    73Modifier 73 indicates a facility-level outpatient hospital or ASC procedure that was discontinued after the patient was prepared and taken to the procedure/operating room but before any anesthesia…- When to use: Apply CPT modifier 73 on the FACILITY (outpatient hospital or ASC) claim when the patient has been fully prepared and physically taken into the procedure/operating room but the…
    74Modifier ‑74 indicates an outpatient hospital or ASC procedure that was discontinued after anesthesia was administered and after the procedure had begun. Use this modifier when anesthesia (local,…- Use modifier -74 when a procedure in an outpatient hospital or ASC setting is terminated after anesthesia has been administered and after the procedure has commenced (for example, after incision,…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…

    Showing 1–10 of 12

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    208100000X
    207P00000X
    333600000X
    2084N0400X
    261QR1100X
    122300000X
    103TP0814X
    305S00000X

    Related ICD-10-CM Codes

    24 rows

    ICD-10-CM CodeDescription
    E10.65Type 1 diabetes mellitus with hyperglycemia
    E78.5Hyperlipidemia, unspecified
    I10Essential (primary) hypertension
    I65.22Occlusion and stenosis of left carotid artery
    I65.23Occlusion and stenosis of bilateral carotid arteries
    I66.9Occlusion and stenosis of unspecified cerebral artery
    I70.0Atherosclerosis of aorta
    I71.9Aortic aneurysm of unspecified site, without rupture
    I72.0Aneurysm of carotid artery
    I72.3Aneurysm of iliac artery

    Showing 1–10 of 24

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

    CPT 35082: Open Repair of Ruptured Abdominal Aortic Aneurysm

    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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