CPT 35241 Intrathoracic Vein Graft Reimbursement | OpenPayer

Summary & Overview

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

CPT code 35241 denotes repair of an abnormal or injured intrathoracic blood vessel using a vein graft performed on cardiopulmonary bypass. This is a high-acuity cardiothoracic vascular surgery typically delivered in hospital operating rooms or cardiac surgery suites and carries implications for operative planning, resource utilization, and payer coverage given the complexity and use of cardiopulmonary bypass.

Key payers commonly involved in coverage decisions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a national perspective on clinical context and billing implications for CPT code 35241, including benchmarks for service setting and utilization patterns, payer coverage considerations, and relevant policy updates affecting high-complexity cardiothoracic procedures.

The report provides practical reference material: a concise description of the procedure and service setting, common billing modifiers and claim considerations (Data not available in the input), and guidance on where to locate additional coding and reimbursement policy details. It is intended for clinicians, coding professionals, and revenue cycle managers seeking a focused summary of the clinical and billing profile for CPT code 35241 at a national level.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare35241CPTcardiothoracic surgerycardiopulmonary bypassvein graftvascular repairinpatient surgery

Billing Code Overview

CPT code 35241 describes surgical repair of an abnormal or injured intrathoracic blood vessel using a vein graft performed while the patient is on cardiopulmonary bypass. The procedure involves replacing or bypassing damaged sections of intrathoracic vasculature to restore circulation within the thoracic cavity.

Service type: Cardiothoracic vascular surgical procedure with cardiopulmonary bypass

Typical site of service: Inpatient operating room or cardiac surgery suite (hospital-based)

Clinical & Coding Specifications

Clinical Context

A typical patient is a 62-year-old male presenting with a traumatic or iatrogenic injury to an intrathoracic blood vessel (for example, a tear of the intrathoracic segment of the subclavian artery during thoracic surgery or a complex aneurysmal disease involving a thoracic branch vessel). After initial resuscitation in the emergency department or stabilization in the operating room, the patient is taken to the cardiovascular operating suite. Preoperative imaging (CT angiography or conventional angiography) documents the vascular lesion. The cardiac surgery team initiates general endotracheal anesthesia and establishes cardiopulmonary bypass to provide a bloodless field and organ perfusion. The surgeon harvests an autologous vein graft (commonly the saphenous vein), prepares the intrathoracic vessel, and performs repair or bypass of the injured or diseased segment using the vein graft while on bypass. Intraoperative monitoring includes transesophageal echocardiography and arterial line monitoring. The patient is transferred postoperatively to the cardiovascular intensive care unit for hemodynamic support, ventilator management, and monitoring for bleeding, graft patency, and end-organ perfusion. Typical workflow steps: preoperative assessment and consent, anesthesia induction, cannulation for cardiopulmonary bypass, vein harvest, intrathoracic vessel exposure, graft anastomosis on bypass, decannulation, hemostasis, chest closure, and postoperative critical care monitoring.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier (default)

CPT 35207: Vessel Repair/Ligation, Hand or Finger

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

CPT 35236: Upper-Extremity Arterial Repair with Vein Graft

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

CPT 35216: Open Thoracic Vessel Repair Without Cardiopulmonary Bypass

CPT-35206-UPPER-EXTREMITY-VASCULAR-REPAIR

CPT 35206: Upper Extremity Vascular Repair

CPT-35266-UPPER-EXTREMITY-ARTERIAL-REPAIR-NON-VENOUS-GRAFT

CPT 35266: Upper-Extremity Arterial Repair with Non–Venous Graft

CPT-35286-LOWER-EXTREMITY-NON-VENOUS-GRAFT-REPAIR

CPT 35286: Lower Extremity Blood Vessel Repair with Non‑Venous Graft

CPT-35211-INTRATHORACIC-VESSEL-REPAIR-CARDIOPULMONARY-BYPASS

CPT 35211: Repair of Ruptured Intrathoracic Vessel with Cardiopulmonary Bypass

CPT-35256-LOWER-EXTREMITY-ARTERIAL-REPAIR-WITH-VEIN-GRAFT

CPT 35256: Lower Extremity Blood Vessel Repair with Vein Graft

CPT-35261-NECK-BLOOD-VESSEL-REPAIR-NON-VENOUS-GRAFT

CPT 35261: Neck Blood Vessel Repair With Non–Venous Graft

CPT-35281-INTRA-ABDOMINAL-VESSEL-REPAIR-NON-VENOUS-GRAFT

CPT 35281: Intra‑abdominal Vessel Repair with Non‑Venous Graft

Showing 1–10 of 18

Taxonomy Code	Specialty	Notes
208100000X	Cardiothoracic Surgery	Primary specialty performing intrathoracic vascular repairs on bypass.
207L00000X	Vascular Surgery	May perform complex thoracic vascular reconstructions, often in hybrid cases.
207RX0300X	General Surgery (Thoracic)	Surgeons with thoracic focus who perform intrathoracic vascular procedures in cooperation with cardiac teams.
2080P0800X	Cardiac Surgery	Overlaps with cardiothoracic; emphasizes operative cardiac and intrathoracic procedures.
163W00000X	Emergency Medicine (for initial stabilization)	Involved in emergent presentation and airway/trauma stabilization prior to operative care.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I72.3`	Thoracic aortic aneurysm, without rupture	Thoracic aneurysmal disease can require intrathoracic vessel repair with grafting on cardiopulmonary bypass.
`S25.0`	Injury of intrathoracic artery	Direct traumatic injury to intrathoracic arteries necessitates surgical repair with vein graft and bypass support.
`I74.9`	Embolism and thrombosis of unspecified artery	Acute arterial thrombosis in thoracic vessels may require operative bypass and grafting.
`I71.2`	Thoracic aortic aneurysm, ruptured	Rupture or impending rupture can lead to emergency repair using vein grafts under bypass.
`I77.1`	Stricture of artery	Severe arterial stenosis or occlusive disease in intrathoracic vessels may be treated surgically when endovascular options are unsuitable.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`33340`	Repair of aortic root or ascending aorta, with or without cardiopulmonary bypass	Performed for proximal aortic pathology and may coexist with intrathoracic vessel repairs requiring bypass.
`35476`	Bypass graft, femoral-popliteal; single segment, with vein graft	Example vein graft code for peripheral bypass; conceptually related as vein graft harvesting and use techniques overlap.
`33533`	Coronary artery bypass, using arterial graft; single coronary venous graft, with cardiopulmonary bypass	Demonstrates use of cardiopulmonary bypass and grafting technique; often performed by the same surgical team.
`36147`	Repair of vascular injury (in extremity) using vein graft, not otherwise specified	Related in technique (vein graft to repair vessel injury) though anatomical site differs.
`33999`	Unlisted procedure, cardiac surgery	Used when a specific intrathoracic vascular repair does not have an exact CPT match alongside `35241` for reporting additional unusual cardiac/vascular work.

OpenPayer