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    OpenPayerBilling CodesArteriovenous Fistula Repair ProceduresCPT cpt-35184-congenital-arteriovenous-fistula-repair-extremity
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    CPT 35184: Repair of Congenital Arteriovenous Fistula, Extremity

    Medicare pays $879 on average nationally for this procedure.

    CPT code 35184 describes a surgical procedure in which the surgeon makes an incision to approach and repair a congenital arteriovenous fistula in an extremity; service type: operative vascular repair; typical site of service: hospital operating room or ambulatory surgical center for extremity vascular surgery.

    For related coverage guidance, see recent payer policy updates: Percutaneous Arteriovenous Fistula Creation, Dialysis Services (ESRD) Coverage and Provider Requirements, Total Parenteral Nutrition and Intradialytic Parenteral Nutrition.

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    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.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    37184Transcatheter occlusion or embolization, peripheral vessel(s), any methodEndovascular embolization may be performed before or instead of open repair to reduce flow or obliterate the AVF.
    36010Introduction of catheter, superior or inferior vena cava, diagnosticDiagnostic catheterization and angiography to map the AVF feeders may be performed preoperatively.
    37241Vascular embolization or occlusion, nonintracranial, percutaneous, any methodPercutaneous embolization used as adjunct or alternative to open repair for feeder vessel occlusion.
    35800Revision, with or without graft; of arteriovenous bypass graft for the legIf reconstruction with a graft is required after excision of the fistula, graft revision or bypass codes may apply.
    36478Endovenous ablation, thermal, percutaneous, extremity vein; radiofrequencyVenous interventions for associated venous insufficiency may be performed in staged care.
    99024Postoperative follow-up visit global period relatedPostoperative visits related to surgical global period care (note: payor rules determine billing).

    Related Modifiers

    10 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…
    51Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207P00000X
    2084P0800X
    207RH0000X
    208100000X
    207YS0123X
    2080N0001X
    103TE1100X
    171W00000X

    Related Payer Policy Updates

    Specialty: Dialysis/Renal Replacement1 / 3

    10 rows

    PolicyPayerEffective Date
    Percutaneous Arteriovenous Fistula CreationAmeriHealth Caritas2026-08-01
    Dialysis Services (ESRD) Coverage and Provider RequirementsMississippi Division of Medicaid2026-08-01
    Total Parenteral Nutrition and Intradialytic Parenteral NutritionCentene2026-05-01
    End Stage Renal Disease (ESRD): Renal Dialysispriority health2026-02-01
    Dialysis services (acute and chronic hemodialysis and peritoneal dialysis)UnitedHealthcare2026-01-01
    Home Hemodialysis (HHD) Coverage Criteriasierra health and life2026-01-01
    Home Hemodialysis (HHD) — Coverage CriteriaUnitedHealthcare2026-01-01
    Staff-Assisted Home HemodialysisCigna2025-11-15
    Parsabiv (etelcalcetide) Coverage for Secondary HyperparathyroidismMolina Healthcare2025-10-09
    DefenCath (taurolidine/heparin catheter lock) CoverageMass General Brigham Health Plan2025-09-01

    Related Codes

    CPT-35180-CONGENITAL-ARTERIOVENOUS-FISTULA-REPAIR-HEAD-NECK

    CPT 35180: Repair of Congenital Arteriovenous Fistula, Head and Neck

    CPT-35182-CONGENITAL-ARTERIOVENOUS-FISTULA-REPAIR-ABDOMEN-THORAX

    CPT 35182: Repair of Congenital Arteriovenous Fistula, Abdomen or Thorax

    CPT-35188-ARTERIOVENOUS-FISTULA-REPAIR-HEAD-NECK

    CPT 35188: Repair of Acquired or Traumatic Arteriovenous Fistula, Head/Neck

    CPT-35189-THORACIC-OR-ABDOMINAL-AV-FISTULA-REPAIR

    CPT 35189: Repair of Acquired or Traumatic Arteriovenous Fistula

    CPT-35190-ARTERIOVENOUS-FISTULA-REPAIR-EXTREMITY

    CPT 35190: Repair of Arteriovenous Fistula in Extremity

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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