Summary & Overview
CPT 35305: Thrombus and Plaque Removal from Tibial or Peroneal Artery
CPT code 35305 denotes removal of thrombus and plaque from an initial tibial or peroneal artery, a targeted vascular procedure used to restore distal lower-extremity blood flow. Nationally, procedures addressing tibial and peroneal occlusive disease are important for limb salvage, wound healing, and reducing amputation risk, making accurate coding and payment alignment critical for providers and payers.
Key payers 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 service type associated with CPT code 35305. The publication provides benchmarks and policy-relevant details where available, highlights common billing considerations, and outlines the clinical implications of the procedure for vascular care pathways.
This piece is intended for a national audience of clinicians, coding professionals, and payers. It summarizes what CPT code 35305 represents, why it matters to vascular care and reimbursement, and what stakeholders should expect when encountering this code in claims and clinical documentation. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 35305 describes a procedure in which the provider removes thrombus and atherosclerotic plaque from an initial tibial or peroneal artery. This is an endovascular or open arterial thrombectomy/endarterectomy procedure focused on distal lower-extremity (tibial or peroneal) vessels.
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Service type: Vascular surgical procedure to remove thrombus and plaque from an initial tibial or peroneal artery
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Typical site of service: Hospital operating room or interventional radiology/catheterization suite with possible inpatient or outpatient admission depending on clinical status and complexity
Clinical & Coding Specifications
Clinical Context
A typical patient is a 68-year-old male with peripheral artery disease presenting with acute or subacute ischemic symptoms of the lower leg and foot (rest pain, non-healing ulcer, or progressive claudication) attributable to an occlusive thrombus or atherosclerotic plaque in a tibial or peroneal artery. The vascular surgeon or interventional radiologist evaluates the patient in clinic and orders arterial duplex ultrasound and/or diagnostic lower-extremity angiography. In the angiography suite or hybrid operating room, after vascular access is obtained (commonly via the common femoral artery), diagnostic angiography confirms an obstructive lesion in an initial tibial or peroneal artery. The provider performs mechanical or catheter-directed thrombectomy and/or plaque extraction to remove thrombus and atheromatous material from the targeted tibial or peroneal vessel. Hemostasis is achieved, and the patient is observed in a post-anesthesia care unit with neurovascular checks and anticoagulation/antiplatelet management as indicated. Typical documentation includes indication, pre-procedure imaging, informed consent, access site, devices used, vessels treated, amount and appearance of thrombus/plaque removed, complications (if any), and post-procedure plan including wound care, medication changes, and follow-up imaging or revascularization planning.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Standard reporting when no modifier applies |