Summary & Overview
CPT 35121: Open Repair of Visceral Artery Aneurysm
CPT code 35121 denotes open surgical repair of an aneurysm or pseudoaneurysm of a visceral artery — specifically hepatic, celiac, renal, or mesenteric arteries — via an abdominal incision with direct repair or graft placement. This procedure is clinically significant because visceral artery aneurysms, while less common than other arterial aneurysms, carry risk of rupture, hemorrhage, and end-organ ischemia; prompt definitive surgical management is essential in selected patients.
Key payers covered in this national overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise synthesis of clinical context for CPT code 35121, common sites and service settings, and the types of information typically needed for billing and utilization discussions.
This publication provides benchmarks and coding context — such as typical inpatient hospital operating room use — and highlights policy-relevant points that affect coverage and claims processing for major commercial payers and Medicare. It also identifies gaps where specific payer policy details, ICD-10 diagnosis pairings, and related procedure codes are not available in the input.
Billing Code Overview
CPT code 35121 describes an open abdominal surgical procedure to repair an aneurysm or pseudoaneurysm of a major visceral artery. The surgeon makes an incision into the abdomen to access an aneurysm or pseudoaneurysm in the hepatic, celiac, renal, or mesenteric artery and then performs direct repair or places a graft at the repair site.
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Service type: Open vascular surgical repair of visceral arterial aneurysm or pseudoaneurysm
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Typical site of service: Inpatient or outpatient hospital operating room (abdominal/vascular surgery setting)
Data not available in the input for payers, taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 58-year-old male who presents with abdominal pain and is found on contrast CT angiography to have a 2.8 cm symptomatic splanchnic artery aneurysm arising from the hepatic artery. The patient has hypertension and chronic tobacco use and is scheduled for open surgical repair after vascular surgery consultation because the lesion is not amenable to endovascular treatment. The clinical workflow includes preoperative evaluation (labs, cross-match, anesthesia assessment), informed consent explaining open abdominal exposure and direct arterial repair or interposition graft, intraoperative general endotracheal anesthesia with midline laparotomy for exposure of the hepatic artery, proximal and distal vascular control, aneurysm sac repair or resection with graft placement, hemostasis and abdominal closure. Postoperative care includes ICU monitoring for hemodynamic stability and bleeding, serial hemoglobin checks, vascular graft surveillance with Doppler ultrasound or CT angiography, pain control, and discharge planning with outpatient vascular follow-up.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier (default) | Use when no specific modifier applies and services are standard. |
11 |