Summary & Overview
CPT 35102: Open Repair of Aortic and Iliac Aneurysm
CPT code 35102 represents an open surgical repair of an aortic or iliac aneurysm or pseudoaneurysm performed via an incision in the abdomen and pelvis with direct repair or graft placement. This is a high-acuity vascular surgery code used for definitive treatment of aneurysmal disease when endovascular approaches are unsuitable or unavailable. It is clinically significant because it involves major operative risk, extended inpatient care, and substantial resource utilization across surgical, anesthesia, and critical care services. Nationally, such procedures influence hospital surgical capacity, perioperative protocols, and payer coverage policies for complex vascular disease management.
Key payers typically included in analyses of this code are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for use of the code, typical sites of service, and the kinds of benchmarks and policy considerations that affect coverage and payment for open aortic/iliac repairs. The publication will also summarize common billing modifiers and related administrative issues, explain where data are available or absent, and outline implications for hospital service lines and vascular surgery practice patterns.
Billing Code Overview
CPT code 35102 describes an open surgical procedure in which an incision is made into the abdomen and pelvis to access an aneurysm or pseudoaneurysm of the aorta and iliac vessels. The surgeon performs a direct repair or places a vascular graft at the site of the aneurysm or pseudoaneurysm.
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Service type: Open vascular surgery, surgical repair of aortic/iliac aneurysm or pseudoaneurysm
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Typical site of service: Inpatient hospital operating room or tertiary care surgical center
Clinical & Coding Specifications
Clinical Context
A typical patient is a 72-year-old male with a history of hypertension and peripheral vascular disease who presents with an enlarging infrarenal abdominal aortic aneurysm measuring 6.2 cm on abdominal CT angiography and increasing back pain. Vascular surgery evaluates the patient and determines that open surgical repair is indicated due to aneurysm morphology not amenable to endovascular repair and concern for rupture. The clinical workflow includes preoperative evaluation (cardiac risk assessment, labs, cross-match), informed consent, anesthesia clearance, and marking of the operative site. In the operating room under general anesthesia, the surgeon makes a midline laparotomy or a retroperitoneal incision to expose the aneurysm in the abdominal aorta and/or iliac arteries, controls proximal and distal vessels, and performs either direct repair or insertion of a prosthetic graft. Intraoperative steps include heparinization, aortic cross-clamping, resection or reinforcement of the aneurysmal segment, graft suturing, restoration of flow, hemostasis, and layered closure. Postoperative management includes ICU monitoring, pain control, surveillance imaging as indicated, and discharge planning with follow-up imaging and wound care instructions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Procedure completed as scheduled (no modifier) | Rarely used as a modifier code; present in the list but not commonly appended in claims — billed as usual. |