Summary & Overview
CPT 35132: Open Repair of Ruptured Iliac Artery Aneurysm
CPT code 35132 represents open surgical repair of a ruptured iliac artery aneurysm through an abdominal or retroperitoneal approach, including direct repair or graft placement. This procedure captures high-acuity vascular surgery typically performed emergently in hospital operating rooms and often carries significant clinical and financial implications because of the complexity, risk of hemorrhage, and resource intensity. Nationally, accurate capture of this code is important for quality reporting, payment, and tracking outcomes for major vascular emergencies.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find benchmarks and contextual guidance on clinical setting and coding intent, summaries of payer coverage patterns where available, and notes on common procedural modifiers and administrative considerations. The content outlines clinical context—why the code is used and where the service is typically delivered—as well as operational implications for billing and claims submission.
This summary is intended for a national audience and focuses on clinical definition, site-of-service implications, and the types of administrative information that payers and providers monitor for high-acuity vascular procedures. Data not available in the input is noted where applicable in supporting sections.
Billing Code Overview
CPT code 35132 describes a surgical procedure to repair a ruptured iliac artery aneurysm. The provider makes an abdominal or retroperitoneal incision to access the ruptured aneurysm in the iliac artery and then performs a direct repair or places a graft at the site of repair.
Service type: Open vascular surgical repair
Typical site of service: Hospital inpatient or operating room (abdominal/retroperitoneal access)
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting emergently with sudden-onset severe abdominal, pelvic, or groin pain, hypotension, and signs of hemorrhagic shock. Imaging (CT angiography) or focused assessment may reveal a ruptured or leaking iliac artery aneurysm. The patient is taken to the operating room for open vascular repair via an abdominal or retroperitoneal incision. The vascular surgeon gains proximal and distal control of the affected iliac artery, evacuates hematoma, and performs direct arterial repair or interposition graft placement (autologous vein or prosthetic graft) to restore perfusion and control hemorrhage. Intraoperative steps include general endotracheal anesthesia, arterial and central venous access, blood product availability, systemic heparinization as indicated, vascular clamps, debridement of the rupture site, and sutured repair or graft anastomosis. Postoperative care includes intensive monitoring in a surgical ICU for hemodynamic stabilization, wound care, graft surveillance, and management of complications such as bleeding, infection, limb ischemia, or renal dysfunction.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier — default | Use when no additional modifier is applicable; standard reporting of the procedure |
11 |