Summary & Overview
CPT 35184: Repair of Congenital Arteriovenous Fistula, Extremity
CPT code 35184 represents surgical repair of a congenital arteriovenous fistula in an extremity. The code captures operative management that involves incision, exposure, and repair of abnormal arteriovenous connections, a procedure relevant to vascular and pediatric vascular surgery. Nationally, accurate coding of congenital arteriovenous fistula repair affects claims processing, quality measurement, and access to appropriate surgical care for patients with symptomatic or limb‑threatening lesions.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, typical sites of service, and the service type tied to the code. The publication provides benchmarks and coding considerations relevant to hospital and ambulatory surgical settings, highlights policy and reimbursement updates where available, and situates the procedure within broader vascular surgical practice.
The content addresses how this code is used in clinical documentation and billing workflows, common payer coverage patterns, and areas where additional documentation supports appropriate coding. Data not available in the input is noted where relevant; the summary focuses on nationally applicable information for clinicians, coding professionals, and revenue cycle stakeholders.
Billing Code Overview
CPT code 35184 describes a surgical procedure in which the provider makes an incision to approach a congenital arteriovenous fistula in an extremity and performs repair of the fistula. This procedure is a surgical repair of a congenital arteriovenous fistula of the extremity, involving operative exposure and definitive repair of abnormal vascular connections.
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Service type: Surgical procedure — vascular repair
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Typical site of service: Hospital operating room or ambulatory surgical center
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is a pediatric or young adult presenting with a congenital arteriovenous fistula (AVF) of an extremity, most commonly the upper or lower limb, causing pain, swelling, limb ischemia or high-output cardiac symptoms. The vascular surgeon or pediatric vascular specialist evaluates the patient with history and focused exam, orders diagnostic vascular imaging such as duplex ultrasound, CT angiography or catheter-based angiography to delineate the fistula anatomy and feeding/returning vessels. Preoperative planning includes assessment of limb perfusion, neurologic status, and potential need for grafts or vessel reconstruction. In the operating room or hybrid endovascular suite, the provider makes an incision to expose the congenital AVF, controls proximal and distal flow, and repairs the fistula by ligation, excision of the fistulous segment, primary repair, or interposition graft as indicated. Intraoperative adjuncts may include blood loss control, intraoperative angiography, and heparinization. Postoperative care involves monitoring for bleeding, limb perfusion, wound care, and follow-up imaging to confirm repair integrity and absence of recurrent shunting.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier — default billing | Use when no specific modifier applies to the service performed. |