CPT 35571 Popliteal Bypass Reimbursement | OpenPayer

Summary & Overview

CPT 35571: Popliteal to Tibial/Peroneal Arterial Bypass

CPT code 35571 denotes a surgical bypass of the popliteal artery to a tibial, peroneal, or other distal vessel using a graft or autologous vein. It captures a major vascular reconstruction intended to bypass damaged or occluded segments of the popliteal artery and re-establish arterial inflow to the lower extremity. Nationally, this procedure carries clinical importance for limb salvage, management of critical limb ischemia, and complex peripheral arterial disease.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a concise review of coding context and the clinical setting for 35571, along with payer coverage considerations and common modifiers used with major vascular procedures. Readers will find operational benchmarks, concise policy and coverage highlights, clinical context for when the service is performed, and guidance on common documentation elements relevant to billing and claims adjudication. Data not available in the input for associated taxonomies, specific ICD-10 diagnoses, and related codes are noted as unavailable.

This resource is organized to help coding, billing, and surgical teams quickly understand the clinical intent of 35571, typical sites of service, and the payer landscape for this high-acuity vascular procedure.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare35571CPTvascular-surgerylower-extremity-bypasspopliteal-arteryarterial-bypasslimb-salvagesurgical-procedure

Billing Code Overview

CPT code 35571 describes a surgical arterial bypass procedure in which the provider creates a popliteal-to-tibial, popliteal-to-peroneal, or popliteal-to-other-vessel bypass using a graft or an autogenous vein harvested from the patient. The procedure is performed to bypass an injured or obstructed segment of the popliteal artery and restore distal lower-extremity arterial blood flow.

Service type: Lower extremity arterial bypass surgery

Typical site of service: Inpatient hospital operating room or hospital-based procedural suite, where vascular surgical procedures and graft harvest are performed.

Clinical & Coding Specifications

Clinical Context

A 68-year-old male with a history of peripheral arterial disease, tobacco use, hypertension, and type 2 diabetes presents with progressive rest pain and nonhealing ischemic ulceration of the lateral aspect of the right foot. Noninvasive vascular testing and angiography demonstrate an occlusive lesion of the popliteal artery with inadequate distal tibial runoff and significant tibial/peroneal disease unsuitable for endovascular-only repair. The vascular surgeon plans an open bypass from the popliteal artery to a tibial or peroneal target using autogenous vein harvested from the patient to restore distal perfusion and promote limb salvage.

Preoperative workflow includes vascular laboratory duplex ultrasound, arterial angiography with possible diagnostic catheter-based run-off assessment, informed consent documenting indication and risks, venous mapping for conduit selection, and medical optimization (antiplatelet therapy, diabetes control, cardiopulmonary assessment). Intraoperative steps include harvest of the greater saphenous vein, exposure of the popliteal artery and chosen tibial/peroneal target, construction of the bypass graft with proximal and distal anastomoses, completion angiography or duplex to confirm flow, and wound closure. Postoperative care involves graft surveillance with duplex ultrasound, antiplatelet/anticoagulation management as indicated, wound care for the ischemic ulcer, and rehabilitation focused on ambulation and risk-factor modification.

Coding Specifications

Modifier	Description	When to Use
`26`

CPT 35501: Carotid Common-to-Internal Artery Bypass Graft

CPT-35523-BRACHIAL-TO-ULNAR-OR-RADIAL-VEIN-BYPASS

CPT 35523: Brachial to Ulnar or Radial Vein Bypass

CPT-35509-CAROTID-TO-CAROTID-VEIN-BYPASS-GRAFT

CPT 35509: Carotid-to-Carotid Bypass with Vein Graft

CPT-35570-TIBIAL-PERONEAL-ARTERY-BYPASS

CPT 35570: Tibial and Peroneal Artery Bypass Procedures

CPT-35512-SUBCLAVIAN-TO-BRACHIAL-ARTERY-VEIN-BYPASS

CPT 35512: Subclavian-to-Brachial Artery Vein Bypass

CPT-35539-AORTO-FEMORAL-VEIN-BYPASS-GRAFT

CPT 35539: Aorto-Femoral Vein Bypass Graft

CPT-35566-FEMORAL-TO-TIBIAL-PERONEAL-BYPASS

CPT 35566: Femoral-to-Tibial/Peroneal Arterial Bypass

CPT-35508-CAROTID-TO-VERTEBRAL-BYPASS-GRAFT

CPT 35508: Carotid-to-Vertebral Artery Bypass Graft

CPT-35540-AORTO-BIFEMORAL-VEIN-BYPASS-GRAFT

CPT 35540: Aorto‑bifemoral Vein Bypass Graft

CPT-35525-BRACHIAL-ARTERY-BRACHIAL-ARTERY-VEIN-BYPASS-GRAFT

CPT 35525: Brachial Artery-to-Brachial Artery Vein Bypass

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Taxonomy Code	Specialty	Notes
207P00000X	Vascular Surgery	Primary specialty performing lower extremity arterial bypass procedures.
2080P0200X	General Surgery	General surgeons with vascular training may perform lower extremity bypass.
2087S0122X	Thoracic and Cardiac Surgery	Cardiac/vascular surgeons who perform complex peripheral bypasses as part of vascular practice.
207RC0000X	Interventional Radiology	Performs diagnostic and endovascular procedures; may collaborate for imaging/angiography during bypass procedures.
363L00000X	Podiatry (Surgery)	Podiatric surgeons may participate in distal target management and wound care in limb salvage cases.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I70.213`	Atherosclerosis of native arteries of the extremities with rest pain, right leg	Common indication for popliteal-to-tibial/peroneal bypass to relieve ischemic rest pain in the right leg.
`I70.214`	Atherosclerosis of native arteries of the extremities with rest pain, left leg	Same clinical indication for left-sided bypass.
`I70.231`	Atherosclerosis of native arteries of the extremities with ulceration, right leg	Indicates ischemic ulceration often requiring bypass for limb salvage.
`I70.232`	Atherosclerosis of native arteries of the extremities with ulceration, left leg	Indicates ischemic ulceration on the left requiring revascularization.
`I70.241`	Atherosclerosis of native arteries of the extremities with gangrene, right leg	Advanced ischemia with gangrene often necessitating urgent bypass or amputation decisions.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`33533`	Revascularization, aorto-coronary bypass, with vein graft(s); single arterial graft (Note: unrelated cardiac code)	Data not available in the input.
`36818`	Embolectomy, thrombectomy, or bypass of tibial or peroneal artery (open)	May be performed when distal tibial/peroneal thrombosis requires concomitant thrombectomy or bypass of smaller tibial vessels during limb salvage.
`35566`	Bypass graft, with vein; femoral-popliteal, single segment, above knee	Performed for more proximal femoral-popliteal disease; may be performed in conjunction or as alternative to popliteal-to-tibial bypass depending on disease level.
`35786`	Deep femoral to femoral bypass grafting with vein	Part of broader revascularization strategies when multilevel disease requires staged or combined bypass procedures.
`75962`	Transcatheter angiography, selective, arterial (includes percutaneous transluminal angioplasty when performed)	Used for diagnostic angiography or intraoperative completion angiography to assess bypass patency.

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