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    v1.0.30
    OpenPayerBilling CodesBypass Graft Procedures Other Than VeinCPT cpt-35602-carotid-to-carotid-prosthetic-arterial-bypass
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    CPT 35602: Carotid-to-Carotid Bypass with Prosthetic Graft

    CPT code 35602 describes surgical creation of a carotid-to-carotid bypass using a non-vein graft (for example, a prosthetic tube) to reroute blood between the carotid arteries when one side or adjacent vessels are blocked, narrowed, or intentionally excluded during aortic repair; service type: open vascular bypass surgery; typical site of service: inpatient or operating room vascular surgery setting where arterial reconstruction is performed.

    For related coverage guidance, see recent payer policy updates: Surgical Procedures, Outpatient Surgical Procedures - Site of Service, Site of Service Ambulatory Service Center (ASC) Select — Surgical or Diagnostic Procedures in Adults.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is a 68-year-old male with progressive right-sided carotid occlusive disease and contralateral high-grade stenosis who presents with recurrent transient ischemic attacks (TIAs) despite maximal medical therapy. Preoperative evaluation includes carotid duplex ultrasound showing an occluded right internal carotid artery and 80% stenosis of the left internal carotid artery, CTA of the neck and chest to define anatomy, and cardiac evaluation to assess surgical risk. The vascular surgery team plans a cross-neck carotid bypass using a prosthetic tube graft (CPT 35602) to re-establish flow to the occluded carotid circulation and protect cerebral perfusion during an anticipated staged aortic arch or complex carotid reconstruction.

    Perioperative workflow: the patient is admitted, consented, and optimized (antiplatelet management, blood pressure control). In the operating room under general anesthesia, bilateral neck exposures are performed, the prosthetic graft is measured and tunneled subcutaneously across the neck, and end-to-side anastomoses are constructed between the donor and recipient carotid arteries. Intraoperative neuromonitoring (EEG/SSEP) and completion angiography or duplex confirm patency. Postoperative care includes ICU monitoring for neurologic status, blood pressure control, antiplatelet therapy, and staged imaging prior to discharge and follow-up surveillance duplex ultrasound.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    36215Selective catheter placement, carotid, unilateral, with angiography radiological supervision and interpretationUsed for diagnostic cerebral/neck angiography preoperatively or intraoperatively to define anatomy and confirm graft patency

    36247 | Introduction of catheter, arterial, retrograde, for diagnostic cerebral angiography | Alternative access angiography code for diagnostic vascular imaging associated with planning or completion angiograms

    35301 | Transposition of carotid artery (e.g., subclavian-carotid transposition) | Related open revascularization technique; may be an alternative to a cross-neck prosthetic bypass depending on anatomy

    33405 | Repair of aortic arch or ascending aorta (example code for open arch procedures) | Represents major aortic procedures during which carotid flow may be rerouted or bypassed; included when carotid bypass is adjunctive in aortic repair

    93880 | Duplex scan of extracranial arteries, complete bilateral study | Common postoperative and surveillance imaging to assess graft patency and flow after carotid bypass

    92920 | Percutaneous transluminal balloon angioplasty, peripheral arterial, femoral-popliteal, etc. (representative endovascular revascularization) | Represents potential endovascular adjuncts or staged procedures when hybrid approaches are used

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…
    24Modifier 24 denotes an unrelated evaluation and management (E/M) service performed by the same physician or qualified healthcare professional during a postoperative global period. Per CPT guidance,…- Use modifier 24 when you report an evaluation and management (E/M) service performed by the same physician or same-specialty group during a procedure’s postoperative global period that is unrelated…
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    P6Modifier P6 indicates a declared brain‑dead patient whose organs are being removed for donor purposes. It is part of the Anesthesia Physical Status Modifiers (P1–P6) and corresponds to ASA VI. The…- When to use: Append CPT modifier P6 to anesthesia codes in the 00100–01999 range when the anesthesia provider documents a declared brain‑dead patient whose organs are being removed for donor…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207P00000X
    207R00000X
    207L00000X
    207K00000X
    2251E1300X
    261QP1100X
    163WP0218X
    213ES0000X

    Related Payer Policy Updates

    Specialty: General Surgery1 / 2

    10 rows

    PolicyPayerEffective Date
    Surgical ProceduresUnitedHealthcare2026-09-01
    Outpatient Surgical Procedures - Site of ServiceUnitedHealthcare2026-09-01
    Site of Service Ambulatory Service Center (ASC) Select — Surgical or Diagnostic Procedures in AdultsPremera Bluecross2026-09-01
    Site of Service Ambulatory Surgical Center (ASC) Select — Surgical or Diagnostic Procedures in AdultsPremera Bluecross2026-09-01
    Site of Service Ambulatory Service Center (ASC) SelectPremera Bluecross2026-09-01
    Site of Service Ambulatory Surgical Center (ASC) Select — Site of Service for Ambulatory Surgical Procedures (ASC Select)Premera Bluecross2026-09-01
    Site of Service Ambulatory Service Center (ASC) SelectPremera Bluecross2026-09-01
    Outpatient Surgical Procedures - Site of Servicesierra health and life2026-08-01
    Medical Necessity Guidelines — Inpatient Surgical CareMass General Brigham Health Plan2026-08-01
    Ambulatory Surgery Center (ASC) - Site of Care PolicyKaiser Permanente2026-08-01

    Related Codes

    CPT-35600-ARTERIAL-GRAFT-HARVEST-ARM-FOR-CORONARY-BYPASS

    CPT 35600: Arm Artery Harvest for Coronary Bypass

    CPT-35601-CAROTID-COMMON-ARTERY-BYPASS-SYNTHETIC-GRAFT

    CPT 35601: Common Carotid Artery Bypass with Synthetic Graft

    CPT-35606-SUBCLAVIAN-ARTERY-BYPASS-SYNTHETIC-GRAFT

    CPT 35606: Subclavian Artery Bypass with Synthetic Graft

    CPT-35612-SUBCLAVIAN-ARTERY-BYPASS-SYNTHETIC-GRAFT

    CPT 35612: Subclavian Artery Bypass with Synthetic Graft

    CPT-35616-SUBCLAVIAN-TO-AXILLARY-BYPASS-SYNTHETIC-GRAFT

    CPT 35616: Subclavian to Axillary Bypass with Synthetic Graft

    CPT-35621-AXILLOFEMORAL-BYPASS-SYNTHETIC-GRAFT

    CPT 35621: Axillary–Femoral Bypass with Synthetic Graft

    CPT-35623-AXILLARY-TO-POPLITEAL-OR-TIBIAL-BYPASS-SYNTHETIC-GRAFT

    CPT 35623: Axillofemoral to Popliteal/Tibial Bypass with Synthetic Graft

    CPT-35626-AORTIC-TO-SUBCLAVIAN-INNOMINATE-CAROTID-BYPASS-GRAFT

    CPT 35626: Aortic-to-Subclavian/Innominate/Carotid Bypass with Synthetic Graft

    CPT-35631-AORTO-VISCERAL-RENAL-BYPASS-SYNTHETIC-GRAFT

    CPT 35631: Aorto-Visceral Bypass with Synthetic Graft

    CPT-35632-ILIAC-TO-CELIAC-SYNTHETIC-GRAFT-BYPASS

    CPT 35632: Iliac-to-Celiac Arterial Bypass with Synthetic Graft

    Showing 1–10 of 27

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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