Summary & Overview
CPT 35111: Open Repair of Splenic Artery Aneurysm or Pseudoaneurysm
CPT code 35111 describes an open abdominal operation to expose a splenic artery aneurysm or pseudoaneurysm and perform direct repair or interposition grafting. This code represents definitive surgical management for a potentially life-threatening vascular lesion and is relevant to vascular surgeons, hospital surgical services, and payers overseeing high-acuity inpatient procedural care. Nationally, the code matters because it captures resource-intensive, operating-room-based vascular reconstruction with implications for surgical quality, utilization tracking, and inpatient payment policy.
Key payers considered in this publication include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, coding and billing considerations, common modifiers and service-line implications, and typical sites of service. The report also outlines benchmarks and payment policy updates where available and highlights clinical indications and procedural scope to aid coding accuracy. Data not available in the input is explicitly noted where applicable.
Billing Code Overview
CPT code 35111 describes an open surgical procedure in which the surgeon makes an abdominal incision to access an aneurysm or pseudoaneurysm of the splenic artery and then performs direct arterial repair or places a graft at the repair site. This procedure is a vascular surgical repair of the splenic artery and involves operative management of arterial wall defect or dilation.
Service Type: Open vascular surgery; arterial repair/grafting
Typical Site of Service: Inpatient or operating room setting within a hospital (abdominal surgical suite)
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with a history of hypertension and atherosclerotic vascular disease presents with left upper quadrant abdominal pain and imaging demonstrating a 2.5-cm true aneurysm of the splenic artery. After preoperative evaluation, the vascular surgery team schedules an open repair under general anesthesia. In the operating room, an upper midline or left subcostal abdominal incision is made to expose the proximal and distal splenic artery. The surgeon performs proximal and distal control, then either performs direct arterial repair (aneurysm excision with end-to-end anastomosis) or interposes a prosthetic or autogenous graft to reconstruct the artery. Intraoperative decisions may be influenced by aneurysm morphology, collateral flow to the spleen, and patient comorbidities; splenectomy may be required if arterial reconstruction is not feasible or if the spleen is nonviable. Postoperative workflow includes monitoring in a post-anesthesia care unit or intensive care setting as indicated, serial hemoglobin/hematocrit checks, abdominal imaging if concern for leak or recurrent bleeding, and follow-up visits for wound and vascular assessment.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Not a real CMS modifier (placeholder) | Data not used clinically; do not apply for billing |
11 |