Summary & Overview
CPT 35511: Subclavian-to-Subclavian Vein Bypass Graft
CPT code 35511 denotes an open vascular bypass where a vein graft connects one subclavian artery to the opposite subclavian artery to bypass an occlusion. This procedure is clinically significant for restoring arterial inflow to the upper extremities and posterior cerebral circulation in patients with subclavian artery occlusive disease or steal phenomena. Nationally, charges and utilization for complex vascular reconstructions like this influence hospital surgical service planning, vascular surgery resource allocation, and payer coverage policies for advanced revascularization techniques.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical intent and typical care setting for the procedure, common modifiers and billing considerations supplied in the input, and a summary of where to locate related coding and policy guidance. The brief also highlights expected documentation elements, the typical inpatient hospital operating room setting, and expected clinical contexts for use. Data not provided in the input—such as specific ICD-10 diagnosis pairings, payer-specific reimbursement rates, and taxonomy mappings—are noted as unavailable. This publication serves as a practical reference for coding teams, billing professionals, and policy staff seeking a national-level understanding of CPT code 35511 and its place in vascular surgical service lines.
Billing Code Overview
CPT code 35511 describes a surgical bypass in which the provider creates a graft connecting one subclavian artery to the contralateral subclavian artery using a vein graft to bypass an arterial blockage. The procedure is a vascular surgical bypass intended to restore or improve arterial blood flow to the upper extremity or vertebrobasilar circulation by routing flow between the subclavian arteries.
-
Service type: Open vascular bypass grafting procedure
-
Typical site of service: Hospital operating room or inpatient surgical setting
Clinical & Coding Specifications
Clinical Context
A typical patient is a 65-year-old with progressive left upper extremity claudication, diminished brachial pulses, and imaging-confirmed occlusive subclavian artery disease not amenable to percutaneous angioplasty or stenting. The patient has risk factors such as hypertension, hyperlipidemia, and peripheral arterial disease. After noninvasive studies (duplex ultrasound, CT angiography) demonstrate a chronic high-grade stenosis or occlusion of one subclavian artery with inadequate collateral circulation and persistent ischemic symptoms, vascular surgery evaluates the patient for open revascularization.
In the operating room under general anesthesia, the vascular surgeon harvests an autogenous vein graft (commonly the ipsilateral or contralateral greater saphenous vein), exposes both subclavian arteries through supraclavicular and infraclavicular approaches as needed, and constructs a bypass from one subclavian artery to the contralateral subclavian artery to restore inflow to the ischemic limb. Intraoperative monitoring includes arterial line pressure, duplex or completion angiography to verify graft patency, and anticoagulation per protocol. Postoperative care occurs in a monitored setting with vascular checks, wound care, and antiplatelet therapy. Discharge planning includes surveillance duplex imaging and risk-factor modification.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
62 | Two surgeons | When another surgeon of equal specialty performs distinct portions of the bypass procedure simultaneously. |