Summary & Overview
CPT 35271: Intrathoracic Vessel Repair with Non‑venous Graft and Bypass
CPT code 35271 represents open surgical repair of an abnormal or injured intrathoracic blood vessel using a non–venous graft with cardiopulmonary bypass. This code captures complex cardiothoracic vascular reconstruction performed under cardiopulmonary support and is relevant for hospital-based surgical services and reimbursement classification. Nationally, it identifies high-acuity operative episodes that drive surgical resource use, inpatient length of stay, and perioperative risk stratification.
Key payers evaluated in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a national perspective on coding intent and clinical context for 35271, an overview of how payers typically handle authorization and coverage for high-complexity cardiothoracic vascular procedures, and benchmarks related to service setting and utilization. The publication also summarizes policy and billing considerations relevant to hospital surgical service lines, highlights common documentation points tied to cardiopulmonary bypass use, and outlines where additional coding detail or diagnosis linkage is often required.
Data not available in the input for specific reimbursement rates, associated taxonomies, or ICD-10 diagnosis mappings. The content focuses on code definition, clinical setting, payer scope, and what readers should expect when reviewing claims and policy language related to this procedure.
Billing Code Overview
CPT code 35271 describes surgical repair of an abnormal or injured intrathoracic blood vessel using a non–venous graft while the patient is supported with cardiopulmonary bypass. This procedure is a cardiothoracic vascular repair typically performed in an operative setting with full cardiopulmonary bypass support.
-
Service type: Open cardiothoracic vascular surgery involving graft repair
-
Typical site of service: Inpatient operating room or cardiac surgery suite within a hospital setting
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with a history of atherosclerotic disease and hypertension presents with acute chest pain and imaging that demonstrates a traumatic or iatrogenic injury to an intrathoracic artery requiring operative repair. The cardiovascular surgery team prepares the patient for open repair of the abnormal intrathoracic blood vessel using a non-venous interposition graft (for example, synthetic Dacron or PTFE) with full cardiopulmonary bypass support. Preoperative workflow includes cardiovascular evaluation, informed consent, anesthesia assessment, cross-matching blood, and coordination with perfusion services. Intraoperative workflow involves median sternotomy or thoracotomy, institution of cardiopulmonary bypass, excision or exclusion of the damaged vessel segment, implantation of the non-venous graft, hemostasis, and weaning from bypass. Postoperative workflow includes intensive care monitoring, ventilatory support as needed, chest tube management, graft surveillance with imaging as indicated, anticoagulation management if required, and discharge planning with follow-up in cardiothoracic surgery clinic.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work required is substantially greater than usual for 35271 (document increased complexity). |