Summary & Overview
CPT 35286: Lower Extremity Blood Vessel Repair with Non‑Venous Graft
CPT code 35286 denotes repair of an abnormal or injured blood vessel in the lower extremity using a non–venous graft. This vascular surgery code covers procedures aimed at restoring arterial or non-venous conduit integrity in the leg and is relevant to hospitals, vascular surgery practices, and payers managing complex procedural care. Nationally, procedures coded with 35286 are important because they relate to limb salvage, trauma reconstruction, and management of peripheral vascular disease complications, with implications for surgical resource use and postoperative care.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical context for the code, the typical service setting, and the types of documentation elements that support billing for vascular graft repair. The publication also outlines benchmarks and policy considerations relevant to coverage and coding for non-venous graft procedures, and highlights clinical and billing nuances that affect claim adjudication and payment. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 35286 describes a surgical procedure in which the provider repairs an abnormal or injured blood vessel in the lower extremity using a non–venous graft. This procedure is a vascular surgical repair focused on arterial or other non-venous conduit reconstruction in the leg.
-
Service type: Surgical vascular repair using a non-venous graft
-
Typical site of service: Operating room or other inpatient/outpatient surgical setting where vascular reconstruction is performed
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 68-year-old male with progressive left lower extremity ischemia presenting with rest pain and a non-healing ulcer of the forefoot. Diagnostic workup includes arterial duplex ultrasound and CT angiography confirming an occlusive segment of the superficial femoral and popliteal artery with inadequate autogenous vein conduit due to prior vein harvesting. The vascular surgery team schedules an open repair with a non-venous prosthetic graft to bypass the diseased segment. The workflow includes preoperative evaluation (medical clearance, imaging review, informed consent), intraoperative steps (general or regional anesthesia, exposure of the common femoral and distal target artery, preparation of a non-venous graft such as PTFE or Dacron, proximal and distal anastomoses, completion angiography), and postoperative care (vascular exam monitoring, anticoagulation management, wound care, and surveillance duplex studies). The procedure addresses an abnormal or injured lower extremity artery using a non-venous graft in cases where autogenous conduit is unsuitable or unavailable. Applicable sites of service are an inpatient hospital operating room, hospital outpatient surgical suite, or an ambulatory surgery center depending on clinical status and payer policies.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the surgeon's professional component separate from technical facility charges (rare for operative procedures billed by the surgeon). |