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    v1.0.30
    OpenPayerBilling CodesBypass Graft Procedures Other Than VeinCPT cpt-35632-iliac-to-celiac-synthetic-graft-bypass
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    CPT 35632: Iliac-to-Celiac Arterial Bypass with Synthetic Graft

    Medicare pays $1637 on average nationally for this procedure.

    CPT code 35632 describes a surgical arterial bypass using a synthetic graft to reroute blood flow from the iliac artery around an occluded segment of the celiac artery; this is a vascular surgical bypass procedure typically performed in an operating room or other inpatient/surgical suite setting to restore mesenteric arterial perfusion.

    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 68-year-old male with a history of peripheral arterial disease, tobacco use, and chronic mesenteric ischemia presents with postprandial abdominal pain, unintentional weight loss, and failure to thrive. Imaging with CT angiography demonstrates high-grade stenosis or occlusion of the celiac artery with inadequate collateral flow. After multidisciplinary evaluation, the vascular surgeon elects to perform an open extra-anatomic bypass using a synthetic graft from the common or external iliac artery to the celiac artery to restore antegrade mesenteric perfusion.

    The clinical workflow includes preoperative assessment with cardiac and pulmonary clearance, vascular imaging review, informed consent, intraoperative exposure of the iliac artery and celiac artery via laparotomy or retroperitoneal approach, anastomosis of a prosthetic graft to bypass the obstructed segment, verification of graft patency with Doppler or completion angiography, hemostasis, and postoperative monitoring in a step-down or intensive care setting with antiplatelet therapy and surveillance imaging as indicated.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    35632Bypass graft, with other than venous conduit, from iliac artery to celiac artery; with synthetic graftPrimary procedure: open extra-anatomic bypass using a synthetic graft to revascularize the celiac artery.
    36245Selective catheter placement, celiac trunk, with angiographyOften performed preoperatively or intraoperatively to define celiac anatomy and confirm distal runoff.
    36147Introduction of needle and/or catheter for diagnostic angiography, visceral arteryUsed for diagnostic visceral angiography when assessing mesenteric circulation preoperatively.
    75952Percutaneous transluminal angioplasty, percutaneous, including radiological supervision and interpretation; each vesselMay be attempted as an endovascular alternative or adjunct to open bypass when anatomy permits.
    34820Repair, arterial, with prosthetic graft, with direct anastomosis to visceral artery (example code for complex arterial reconstruction)Represents related arterial reconstruction techniques that may be performed when visceral branches require direct repair or bypass; used in intraoperative decision-making.
    93975Duplex scan of abdominal vessels (lack of a single definitive CPT for mesenteric duplex)Noninvasive surveillance study used pre- and postoperatively to assess graft patency and mesenteric flow.

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    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…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207RG0100X
    2080P0207X
    2084P0800X
    2085R0203X
    207K00000X
    174400000X
    2472B0301X
    3747A0650X

    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-35602-CAROTID-TO-CAROTID-PROSTHETIC-ARTERIAL-BYPASS

    CPT 35602: Carotid-to-Carotid Bypass with Prosthetic 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

    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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