Summary & Overview
CPT 35236: Upper-Extremity Arterial Repair with Vein Graft
CPT code 35236 represents surgical repair of an abnormal or injured blood vessel in an upper extremity using a vein graft. This code captures an operative vascular procedure aimed at reestablishing arterial continuity and perfusion when primary repair is not feasible. The code is clinically significant because upper-extremity arterial injuries and degenerative arterial disease can lead to limb-threatening ischemia, functional impairment, and increased resource use when not repaired effectively.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for vein graft repair in the upper extremity, typical sites of service, and the procedural scope captured by the code. The publication summarizes national billing and coding considerations, common claim modifiers, and benchmarking elements where available. It also outlines relevant clinical indications and documentation points that commonly determine coding and payment outcomes.
This summary equips clinical coders, billing managers, and policy analysts with a clear understanding of what CPT code 35236 represents, why it matters for vascular surgery services, and what to expect in terms of service setting and payer coverage patterns. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 35236 describes surgical repair of an abnormal or injured blood vessel in an upper extremity using a vein graft. This procedure is a vascular repair with interposition grafting performed to restore arterial continuity and blood flow in the arm or hand when the native vessel is damaged, obstructed, or otherwise unsuitable for direct repair.
Service Type: Operative vascular surgery — vein grafting for upper extremity arterial repair
Typical Site of Service: Operating room or surgical suite in an inpatient or outpatient hospital setting; may also be performed in ambulatory surgery centers when clinically appropriate.
Clinical & Coding Specifications
Clinical Context
A 58-year-old male construction worker presents to the vascular surgery service after sustaining a penetrating injury to the forearm with associated pulsatile bleeding, expanding hematoma, and loss of distal pulses. Imaging with duplex ultrasonography and CT angiography confirms transection of the radial artery with segmental loss. The patient is taken to the operating room for exploration and vascular reconstruction. The surgical team harvests an autogenous saphenous vein graft and performs interposition vein graft repair of the injured upper extremity artery to restore distal perfusion. The typical workflow includes preoperative vascular assessment, general or regional anesthesia, operative exposure of the injured vessel, debridement of nonviable ends, measurement of the gap, harvest and preparation of the vein graft, end-to-end anastomoses with microsurgical technique, intraoperative assessment of flow, and postoperative monitoring in a recovery or inpatient setting with anticoagulation and limb perfusion checks.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | When the procedure is performed on the left upper extremity |
RT | Right side |