Summary & Overview
CPT 35281: Intra‑abdominal Vessel Repair with Non‑Venous Graft
CPT code 35281 denotes surgical repair of an abnormal or injured intra‑abdominal blood vessel using a non‑venous graft. This code captures complex vascular reconstructive work that typically occurs in an inpatient surgical setting and is relevant to vascular surgeons, hospital billing departments, and payers overseeing high‑cost surgical encounters. Nationally, procedures coded with 35281 are important for tracking utilization of prosthetic or alternative graft materials and for identifying resource‑intensive operative vascular care.
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 site of service, plus what to expect in benchmarking and policy review sections. The publication outlines how 35281 is used in claims, common clinical scenarios prompting non‑venous graft repair, and areas where payer policies and coverage rules often affect authorization and claim adjudication.
The report provides national benchmarks where available, summaries of relevant payer policy themes, and guidance on coding context such as typical accompanying procedure codes and inpatient surgical service lines. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 35281 describes repair of an abnormal or injured intra–abdominal blood vessel using a non–venous graft. This procedure involves surgical reconstruction of arterial or other intra‑abdominal vascular structures where a prosthetic or alternative graft material is used instead of a venous conduit.
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Service type: Vascular surgical repair with non‑venous graft
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Typical site of service: Inpatient operating room or other surgical setting within a hospital
Clinical & Coding Specifications
Clinical Context
A 62-year-old male with a history of atherosclerotic vascular disease presents with worsening abdominal pain and a pulsatile abdominal mass after recent blunt abdominal trauma. Angiography demonstrates a 3.0 cm pseudoaneurysm of the infrarenal abdominal aorta with disruption of the native vessel wall. The vascular surgery team schedules operative repair with placement of a non-venous graft to reconstruct the injured intra‑abdominal arterial segment.
The clinical workflow includes preoperative imaging (CT angiography), anesthesia evaluation, informed consent, intraoperative exposure of the abdominal aorta (laparotomy or retroperitoneal approach), resection of the damaged arterial segment, and interposition grafting using a prosthetic (non‑venous) conduit. Intraoperative monitoring and possible blood transfusion may be required. Postoperative care includes ICU monitoring for hemodynamic stability, anticoagulation management as indicated, surveillance imaging prior to discharge, and outpatient vascular surgery follow‑up for graft surveillance and wound assessment.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
62 | Two surgeons | Use when two surgeons work together as primary surgeons, each performing distinct portions of a complex vascular reconstruction. |
66 |