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CPT 35211: Repair of Ruptured Intrathoracic Vessel with Cardiopulmonary Bypass

CPT code 35211 describes open surgical repair of a ruptured intrathoracic vessel performed with cardiopulmonary bypass. This procedure is an acute, high-acuity cardiothoracic vascular intervention typically performed in an operating room within an inpatient tertiary care hospital. Nationally, the code captures emergent and complex vascular repairs where bypass support is required, making it relevant to policy discussions on surgical capacity, resource utilization, and payment for high-complexity cardiothoracic care.

Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a compact overview of clinical context, typical sites of service, and common procedure attributes tied to CPT code 35211. The publication outlines benchmark considerations for high-acuity cardiothoracic procedures, highlights how payer coverage patterns can affect access and facility resource planning, and summarizes policy-relevant factors affecting coding and billing for emergent intrathoracic vascular repairs. Service-level details and procedural context are provided to aid coding professionals, billing analysts, and health policy stakeholders in understanding the clinical and operational implications of claims that use CPT code 35211.

Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.

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Billing Code Overview

CPT code 35211 describes surgical repair of a ruptured intrathoracic vessel performed through an appropriate incision with the use of cardiopulmonary bypass. The procedure addresses intrathoracic vascular injuries or ruptures requiring open surgical control and reconstruction.

Service Type: Open cardiothoracic vascular repair with cardiopulmonary bypass

Typical Site of Service: Operating room in an inpatient or tertiary care hospital setting (cardiothoracic surgery)

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CPT 35211: Repair of Ruptured Intrathoracic Vessel with Cardiopulmonary Bypass

Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.

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Billing Code Overview

Service Type: Open cardiothoracic vascular repair with cardiopulmonary bypass

Typical Site of Service: Operating room in an inpatient or tertiary care hospital setting (cardiothoracic surgery)

Clinical & Coding Specifications

Clinical Context

A 62-year-old male presents to the emergency department after blunt chest trauma from a motor vehicle collision. He is hypotensive with expanding hemothorax on chest tube output and CTA of the chest demonstrates active extravasation from an intrathoracic vessel consistent with a ruptured thoracic aortic branch. The patient is taken emergently to the operating room. An appropriate thoracotomy incision is selected based on the vessel location. The cardiothoracic surgical team places the patient on cardiopulmonary bypass to control hemorrhage and obtain a bloodless field, then performs primary repair of the ruptured intrathoracic vessel with sutures or patch graft as indicated. Intraoperative transesophageal echocardiography and vascular imaging guide repair. Postoperatively the patient is transferred to the cardiothoracic intensive care unit for hemodynamic monitoring, ventilatory support as needed, and anticoagulation management per protocol. Typical workflow includes preoperative consent and stabilization, rapid transport to OR, cardiopulmonary bypass initiation, definitive vascular repair, hemostasis confirmation, chest closure, and ICU-level postoperative care.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work or time substantially exceeds typical for `35211` (document justification).
`23`	Unusual anesthesia	Use when general anesthesia cannot be used and an unusual anesthetic is required during `35211`.
`26`	Professional component	Use when reporting only the physician professional component separate from technical component (rare for this operative code).
`59`	Distinct procedural service	Use when a separate, distinct procedural service unrelated to the primary repair is performed in a separate anatomic site or session.
`62`	Two surgeons	Use when two surgeons work together as primary surgeons for the operative repair.
`66`	Surgical team	Use when a surgical team approach is documented for a complex repair under `35211`.
`78`	Return to OR for related procedure during global period	Use when the patient returns to the OR for a related procedure during the global period after `35211`.
`79`	Unrelated procedure during global period	Use when an unrelated procedure is performed during the global period (not listed in raw modifiers but clinically relevant—excluded if strict rule prohibits addition).
`52`	Reduced services	Use when the service was partially reduced or not completed as planned for `35211`.
`53`	Discontinued procedure	Use when the procedure is terminated due to extenuating circumstances after initiation.
`80`	Assistant surgeon	Use when an assistant surgeon participates in the repair and billing requires modifier for assistant.
`62`	Two surgeons	Duplicate entry avoided; only list once.

Taxonomy Code	Specialty	Notes
207K00000X	Thoracic Surgery	Primary specialty performing intrathoracic vessel repairs.
207L00000X	Vascular Surgery	May perform repairs of thoracic vascular injuries in coordination with cardiothoracic team.
207P00000X	Cardiothoracic Surgery	Surgeons trained in cardiopulmonary bypass and intrathoracic vascular repair.
2086S0105X	Emergency Medicine	Involved in initial resuscitation and triage to operative management.
207R00000X	General Surgery	May assist or perform in trauma centers when subspecialists are not available.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S25.81XA`	Other injury of thoracic blood vessel, initial encounter	Directly describes traumatic intrathoracic vessel injury requiring operative repair.
`S25.89XA`	Other injury of thorax, initial encounter	Captures thoracic vascular injuries when more specific code not applicable.
`I71.0`	Dissection of aorta, thoracic	Acute thoracic aortic pathology that may necessitate repair with cardiopulmonary bypass.
`I71.1`	Thoracic aortic aneurysm, ruptured	Ruptured thoracic aneurysm can present similarly and require emergent intrathoracic vascular repair.
`T79.1XXA`	Traumatic hemothorax, initial encounter	Common clinical presentation prompting exploration and repair of bleeding intrathoracic vessels.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`33244`	Insertion of temporary transvenous pacemaker, when performed	May be performed pre- or intraoperatively for management of hemodynamic instability during cardiopulmonary bypass or repair.
`34001`	Thoracic aortography and thoracic aortogram, diagnostic	Performed preoperatively or intraoperatively to localize vascular injury and plan repair.
`34812`	Excision or repair of thoracic great vessels, with cardiopulmonary bypass	Alternative or adjunct procedure when more extensive repair of great vessels is required beyond `35211`.
`99100`	Anesthesia for procedures on infant/child, specific; (example)	Anesthesia codes are reported separately; complex cardiopulmonary bypass cases require appropriate anesthesia coding and documentation.
`36415`	Collection of venous blood by venipuncture	Common ancillary service for labs pre- and postoperatively to monitor hematology and chemistry during care.

CPT 35201: Neck Vessel Repair with Suture

CPT-35206-UPPER-EXTREMITY-VASCULAR-REPAIR

CPT 35206: Upper Extremity Vascular Repair

CPT-35207-HAND-FINGER-VESSEL-REPAIR-CLOSURE

CPT 35207: Vessel Repair/Ligation, Hand or Finger

CPT-35216-THORACIC-VESSEL-REPAIR-OPEN-WITHOUT-BYPASS

CPT 35216: Open Thoracic Vessel Repair Without Cardiopulmonary Bypass

CPT-35221-ABDOMINAL-VESSEL-REPAIR

CPT 35221: Abdominal Blood Vessel Repair

CPT-35226-LOWER-EXTREMITY-VASCULAR-REPAIR

CPT 35226: Repair of Lower Extremity Blood Vessel

CPT-35231-NECK-VESSEL-REPAIR-WITH-VEIN-GRAFT

CPT 35231: Repair of Neck Blood Vessel with Vein Graft

CPT-35236-UPPER-EXTREMITY-ARTERIAL-REPAIR-WITH-VEIN-GRAFT

CPT 35236: Upper-Extremity Arterial Repair with Vein Graft

CPT-35241-INTRATHORACIC-VESSEL-REPAIR-VEIN-GRAFT-CPB

CPT 35241: Intrathoracic Vessel Repair with Vein Graft, on Cardiopulmonary Bypass

CPT-35246-INTRATHORACIC-VASCULAR-REPAIR-VEIN-GRAFT-NO-BYPASS

CPT 35246: Intrathoracic Blood Vessel Repair with Vein Graft, No Bypass

Showing 1–10 of 18

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work or time substantially exceeds typical for `35211` (document justification).
`23`	Unusual anesthesia	Use when general anesthesia cannot be used and an unusual anesthetic is required during `35211`.
`26`	Professional component	Use when reporting only the physician professional component separate from technical component (rare for this operative code).
`59`	Distinct procedural service	Use when a separate, distinct procedural service unrelated to the primary repair is performed in a separate anatomic site or session.
`62`	Two surgeons	Use when two surgeons work together as primary surgeons for the operative repair.
`66`	Surgical team	Use when a surgical team approach is documented for a complex repair under `35211`.
`78`	Return to OR for related procedure during global period	Use when the patient returns to the OR for a related procedure during the global period after `35211`.
`79`	Unrelated procedure during global period	Use when an unrelated procedure is performed during the global period (not listed in raw modifiers but clinically relevant—excluded if strict rule prohibits addition).
`52`	Reduced services	Use when the service was partially reduced or not completed as planned for `35211`.
`53`	Discontinued procedure	Use when the procedure is terminated due to extenuating circumstances after initiation.
`80`	Assistant surgeon	Use when an assistant surgeon participates in the repair and billing requires modifier for assistant.
`62`	Two surgeons	Duplicate entry avoided; only list once.

Taxonomy Code	Specialty	Notes
207K00000X	Thoracic Surgery	Primary specialty performing intrathoracic vessel repairs.
207L00000X	Vascular Surgery	May perform repairs of thoracic vascular injuries in coordination with cardiothoracic team.
207P00000X	Cardiothoracic Surgery	Surgeons trained in cardiopulmonary bypass and intrathoracic vascular repair.
2086S0105X	Emergency Medicine	Involved in initial resuscitation and triage to operative management.
207R00000X	General Surgery	May assist or perform in trauma centers when subspecialists are not available.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S25.81XA`	Other injury of thoracic blood vessel, initial encounter	Directly describes traumatic intrathoracic vessel injury requiring operative repair.
`S25.89XA`	Other injury of thorax, initial encounter	Captures thoracic vascular injuries when more specific code not applicable.
`I71.0`	Dissection of aorta, thoracic	Acute thoracic aortic pathology that may necessitate repair with cardiopulmonary bypass.
`I71.1`	Thoracic aortic aneurysm, ruptured	Ruptured thoracic aneurysm can present similarly and require emergent intrathoracic vascular repair.
`T79.1XXA`	Traumatic hemothorax, initial encounter	Common clinical presentation prompting exploration and repair of bleeding intrathoracic vessels.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`33244`	Insertion of temporary transvenous pacemaker, when performed	May be performed pre- or intraoperatively for management of hemodynamic instability during cardiopulmonary bypass or repair.
`34001`	Thoracic aortography and thoracic aortogram, diagnostic	Performed preoperatively or intraoperatively to localize vascular injury and plan repair.
`34812`	Excision or repair of thoracic great vessels, with cardiopulmonary bypass	Alternative or adjunct procedure when more extensive repair of great vessels is required beyond `35211`.
`99100`	Anesthesia for procedures on infant/child, specific; (example)	Anesthesia codes are reported separately; complex cardiopulmonary bypass cases require appropriate anesthesia coding and documentation.
`36415`	Collection of venous blood by venipuncture	Common ancillary service for labs pre- and postoperatively to monitor hematology and chemistry during care.

CPT 35201: Neck Vessel Repair with Suture

CPT-35206-UPPER-EXTREMITY-VASCULAR-REPAIR

CPT 35206: Upper Extremity Vascular Repair

CPT-35207-HAND-FINGER-VESSEL-REPAIR-CLOSURE

CPT 35207: Vessel Repair/Ligation, Hand or Finger

CPT-35216-THORACIC-VESSEL-REPAIR-OPEN-WITHOUT-BYPASS

CPT 35216: Open Thoracic Vessel Repair Without Cardiopulmonary Bypass

CPT-35221-ABDOMINAL-VESSEL-REPAIR

CPT 35221: Abdominal Blood Vessel Repair

CPT-35226-LOWER-EXTREMITY-VASCULAR-REPAIR

CPT 35226: Repair of Lower Extremity Blood Vessel

CPT-35231-NECK-VESSEL-REPAIR-WITH-VEIN-GRAFT

CPT 35231: Repair of Neck Blood Vessel with Vein Graft

CPT-35236-UPPER-EXTREMITY-ARTERIAL-REPAIR-WITH-VEIN-GRAFT

CPT 35236: Upper-Extremity Arterial Repair with Vein Graft

CPT-35241-INTRATHORACIC-VESSEL-REPAIR-VEIN-GRAFT-CPB

CPT 35241: Intrathoracic Vessel Repair with Vein Graft, on Cardiopulmonary Bypass

CPT-35246-INTRATHORACIC-VASCULAR-REPAIR-VEIN-GRAFT-NO-BYPASS

CPT 35246: Intrathoracic Blood Vessel Repair with Vein Graft, No Bypass

Showing 1–10 of 18

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

CPT 35211: Repair of Ruptured Intrathoracic Vessel with Cardiopulmonary Bypass

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Billing Code Overview

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OpenPayer

CPT 35211: Repair of Ruptured Intrathoracic Vessel with Cardiopulmonary Bypass

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References