Summary & Overview
CPT 35500: Upper-Extremity Vein Harvest for Bypass Conduit
CPT code 35500 reports harvesting a vein from the upper extremity to provide an autogenous conduit for a separately reportable bypass procedure on a coronary artery or lower extremity during the same operative encounter. The code captures a distinct surgical service that facilitates effective revascularization and is important for accurate procedural documentation and payment nationally. Key payers referenced in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical context for vein harvest, guidance on typical settings where the procedure is performed, and an overview of benchmarking and policy considerations that affect coding and reimbursement. The publication reviews common payer coverage patterns, allowed payment ranges and typical billing scenarios, and highlights documentation elements that support correct reporting of 35500. Data not available in the input is noted where applicable. This summary is intended to inform coding professionals, vascular surgeons, and billing administrators about the purpose of CPT code 35500, its role in multi-procedure operative sessions, and the types of analyses and policy updates covered in the full publication.
Billing Code Overview
CPT code 35500 describes harvesting a vein from the upper extremity for use in a separately reportable bypass procedure on a lower extremity or coronary artery performed at the same encounter. This procedure involves removal of a suitable conduit vein from the arm to permit vascular bypass surgery elsewhere in the same operative session.
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Service type: Surgical vein harvest for autogenous bypass conduit
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Typical site of service: Operating room or other inpatient/outpatient surgical setting where vascular bypass procedures are performed
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with peripheral arterial disease and lifestyle-limiting claudication presents for surgical revascularization of the left lower extremity. Diagnostic angiography confirmed an occluded superficial femoral artery with insufficient runoff, and the vascular surgery team plans a femoropopliteal bypass using an autologous vein conduit. During the same operative session, the surgeon harvests the patient’s ipsilateral cephalic vein from the upper extremity for use as the graft.
Preoperative workflow includes vascular laboratory testing, duplex ultrasound mapping of veins, preoperative medical clearance, and informed consent describing combined procedures. Intraoperatively, after induction of anesthesia and preparation of both extremities, the operative team performs the vein harvest through an upper extremity incision, wounds are closed, and the harvested vein is prepared on the back table for the separately reported lower extremity bypass. Postoperative care includes pain control, wound checks at both harvest and bypass sites, anticoagulation management per vascular protocol, and scheduled follow-up for graft surveillance with duplex ultrasound.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When reporting only the physician’s professional component if technical component is billed by facility (rare for this CPT but applicable if split billing applies). |