Summary & Overview
CPT 35122: Open Repair of Ruptured Visceral Artery Aneurysm
CPT code 35122 denotes an open abdominal surgical repair of a ruptured visceral arterial aneurysm (hepatic, celiac, renal, or mesenteric) via direct repair or graft placement. This high-acuity operative code captures emergent vascular interventions that are critical to managing life‑threatening hemorrhage and preserving organ perfusion. Nationally, such procedures have significant clinical and cost implications due to their emergent nature, resource intensity, and frequent inpatient hospitalization.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for CPT code 35122, typical sites of service, and how this code is used in billing for open visceral artery aneurysm repair. The publication highlights common billing modifiers and related administrative considerations, benchmarks where available, and policy or coverage factors that typically affect reimbursement and preauthorization practices for emergent vascular surgery. The content is intended to help billing professionals, vascular surgeons, and hospital coders understand the code’s clinical intent, coding placement, and payer relevance at a national level. Data not available in the input will be noted where applicable.
Billing Code Overview
CPT code 35122 describes an open abdominal surgical procedure to repair a ruptured aneurysm located in a visceral artery, including the hepatic, celiac, renal, or mesenteric artery. The procedure involves an incision into the abdomen to gain access to the aneurysm, followed by direct arterial repair or placement of a graft at the site of repair.
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Service type: Open vascular surgical repair of a ruptured visceral arterial aneurysm
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Typical site of service: Inpatient hospital operating room
Clinical & Coding Specifications
Clinical Context
A 68-year-old male presents to the emergency department with sudden-onset severe abdominal pain, hypotension, and a declining hemoglobin. CT angiography demonstrates a ruptured hepatic artery aneurysm with active extravasation. The patient is taken emergently to the operating room. Under general anesthesia, the vascular surgery team performs a midline laparotomy to expose the hepatoduodenal ligament and proximal hepatic artery. After proximal and distal vascular control, the surgeon performs direct arterial repair with interposition graft placement to restore arterial continuity and control hemorrhage. The procedure includes exploration for associated intra-abdominal bleeding, hemostasis, and placement of drains as indicated. Postoperatively, the patient is transferred to intensive care for hemodynamic monitoring and serial hemoglobin checks, with vascular surgery follow-up for graft surveillance and anticoagulation management as indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier — standard coding | Use when no special modifier applies and the service is routine. |
11 | Default/standard of care | Use to indicate the usual, expected service when no other modifier is appropriate. |