Summary & Overview
CPT 35303: Popliteal Artery Thrombus and Plaque Removal
CPT code 35303 designates a vascular surgical procedure to remove thrombus and atherosclerotic plaque from the popliteal artery. This procedure restores perfusion to the lower extremity and can be performed emergently for acute limb ischemia or electively for obstructive peripheral arterial disease. Nationally, procedures addressing peripheral arterial occlusion have implications for vascular surgery utilization, limb-salvage rates, and hospital resource use.
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, typical sites of service, and the types of documentation and coding considerations tied to CPT code 35303.
This publication summarizes benchmarks and payment context where available, highlights relevant policy and coverage considerations that affect billing for popliteal artery thromboembolectomy/endarterectomy, and outlines common documentation elements that support medical necessity. Data not available in the input is noted where applicable. The goal is to provide a clear national-level briefing for coding, billing, and clinical stakeholders involved in vascular surgical care.
Billing Code Overview
CPT code 35303 describes a surgical procedure in which the provider removes thrombus and plaques from a popliteal artery. This is a targeted arterial thromboembolectomy/endarterectomy procedure aimed at restoring blood flow in the popliteal segment behind the knee.
-
Service type: Vascular surgical procedure involving thrombus and plaque removal
-
Typical site of service: Inpatient or outpatient hospital setting or ambulatory surgical center where vascular surgery is performed
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with acute or chronic limb ischemia of the lower extremity attributed to an occlusive thrombus or atherosclerotic plaque in the popliteal artery. The patient commonly presents with rest pain, worsening claudication, decreased distal pulses, or threatened tissue viability (cool, pale foot, delayed capillary refill). Initial evaluation includes vascular exam, ankle-brachial index (ABI), arterial duplex ultrasound, and often CT angiography or MR angiography confirming focal thrombus or flow-limiting plaque in the popliteal artery.
The clinical workflow begins with pre-procedure assessment by a vascular surgeon or interventionalist, review of imaging, optimization of anticoagulation/antiplatelet therapy, and informed consent. The procedure is typically performed in an operating room or endovascular suite under monitored anesthesia care or general anesthesia. Access is obtained (commonly femoral or popliteal), and the provider performs thrombectomy/endarterectomy or other mechanical removal of thrombus and plaque from the popliteal artery using appropriate instruments (e.g., Fogarty catheter, thrombectomy devices, or open surgical techniques). Completion angiography confirms restoration of flow. Post-procedure care includes monitoring in PACU or inpatient unit, vascular assessments, anticoagulation/antiplatelet management, and follow-up vascular studies.
Typical site of service: Hospital outpatient department or Operating room/endovascular suite depending on approach and inpatient status.
Service type: Surgical — arterial thrombectomy/endarterectomy of the popliteal artery.
Typical patient scenario example: A 68-year-old patient with diabetes and peripheral artery disease presents with worsening right calf claudication and decreased right dorsalis pedis pulse. Duplex and CT angiography show an occlusive thrombus and atherosclerotic plaque in the right popliteal artery. The vascular surgeon schedules an urgent popliteal thrombectomy/endarterectomy with intraoperative angiography and possible patch angioplasty.