Summary & Overview
CPT 35304: Thrombus and Plaque Removal, Tibioperoneal Trunk
CPT code 35304 represents a vascular surgical procedure to remove thrombus and atherosclerotic plaque from the tibioperoneal trunk artery. This procedure is clinically important for restoring arterial blood flow to the lower leg and foot, reducing ischemic risk, and potentially avoiding limb loss. Nationally, such revascularization procedures are significant for vascular surgery caseloads, hospital resource utilization, and postoperative care pathways.
Key payers in the scope of national analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical setting and indications for the procedure, typical sites of service, common modifiers and billing considerations, and how reimbursement and coverage can vary across major payers. The publication summarizes benchmark measures relevant to claims and payment, highlights coding and documentation elements that affect payment, and outlines typical utilization patterns for lower-extremity arterial interventions.
The content is intended to inform coding staff, revenue cycle managers, and policy analysts about the clinical intent and billing context of CPT code 35304, provide a foundation for payer-specific coverage review, and identify areas where documentation influences claim adjudication. Data not provided in the input (such as associated taxonomies, ICD-10 diagnoses, and payer-specific policy details) are noted as unavailable where applicable.
Billing Code Overview
CPT code 35304 describes a surgical procedure in which the provider removes thrombus and plaques from a tibioperoneal trunk artery. This procedure is an arterial thromboendarterectomy or thrombectomy targeted to the tibioperoneal trunk.
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Service type: Vascular surgical arterial thrombus and plaque removal
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Typical site of service: Hospital operating room or vascular surgery suite
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Clinical & Coding Specifications
Clinical Context
A typical patient is a 68-year-old male with peripheral arterial disease who presents with progressive rest pain and nonhealing ulcers of the foot. Noninvasive vascular testing (ABI, arterial duplex ultrasound) and angiography demonstrate an occlusive thrombus and atherosclerotic plaque localized to the tibioperoneal trunk. The vascular surgery or interventional radiology team schedules a lower-extremity arterial thrombectomy/endarterectomy. In the operating room or interventional suite the patient undergoes regional or general anesthesia. Vascular access is obtained, the affected tibioperoneal trunk is exposed or catheterized, and the provider performs mechanical thrombectomy and plaque removal from the tibioperoneal trunk. Hemostasis is achieved, distal flow is confirmed by angiography or duplex, and the patient is recovered and monitored for limb perfusion, bleeding, or access-site complications. Typical sites of service include an inpatient operating room, ambulatory surgery center, or hospital interventional radiology suite. The service type is a surgical arterial thrombectomy/endarterectomy of a lower-extremity tibial trunk artery.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Used when reporting only the physician's professional interpretation component separate from technical services, if applicable for imaging performed with the procedure. |