Summary & Overview
CPT 35276: Intrathoracic Blood Vessel Repair with Non‑Venous Graft, No Bypass
CPT code 35276 denotes surgical repair of an abnormal or injured intrathoracic blood vessel using a non-venous graft performed without cardiopulmonary bypass. This code captures high-acuity vascular reconstruction procedures involving prosthetic or alternative conduits in the thoracic cavity and is relevant for inpatient surgical billing and specialty vascular and cardiothoracic practices. Nationally, correct use of this code affects procedural classification, resource allocation, and payment for complex thoracic vascular repairs.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and typical sites of service, common billing modifiers supplied in the input, and guidance on where to locate related coding and policy materials. The publication summarizes benchmarks and payer coverage considerations where available and highlights areas where input data is not provided.
The article is intended for coding professionals, surgical billing teams, reimbursement analysts, and clinical leaders who need a clear, national-level reference for CPT code 35276. Topics addressed include the clinical scenario the code represents, expected service settings, payer coverage scope, and where to look for additional documentation or payer-specific policy details. Data not available in the input is noted explicitly.
Billing Code Overview
CPT code 35276 describes surgical repair of an abnormal or injured intrathoracic blood vessel using a non-venous graft without cardiopulmonary bypass. The procedure involves placement of a prosthetic or other non-venous conduit to reconstruct or replace part of an intrathoracic artery or large vessel affected by trauma, aneurysm, or other pathology.
Service Type: Surgical vascular reconstruction (intrathoracic) with non-venous graft
Typical Site of Service: Operating room or vascular surgery suite in an acute care hospital, typically performed by cardiothoracic or vascular surgeons given the intrathoracic location and need for operative exposure.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 62-year-old male with a penetrating or traumatic injury to an intrathoracic artery (for example, the intrathoracic subclavian artery or an injury to an intercostal vessel) presenting with persistent intrathoracic hemorrhage and hemodynamic stability sufficient to proceed without cardiopulmonary bypass. The vascular or thoracic surgeon evaluates imaging (CTA chest or intraoperative angiography), confirms an abnormal or injured intrathoracic nonvenous vessel requiring reconstruction, and plans open repair using a synthetic or autologous non-venous graft. The clinical workflow includes preoperative assessment and imaging, operative exposure via thoracotomy or limited thoracic incision, vessel control and debridement, graft selection and anastomosis, intraoperative hemostasis and perfusion assessment, and postoperative monitoring in a surgical step-down unit or intensive care unit depending on physiologic status. Documentation includes the specific vessel repaired, graft type, lack of cardiopulmonary bypass, indication for repair, intraoperative findings, and any complications or concurrent procedures.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the work required to repair the intrathoracic vessel is substantially greater than typical due to complexity or extensive dissection. |