Find policies, billing codes, payers, states, and providers

CPT 35632: Iliac-to-Celiac Synthetic Graft Bypass

CPT code 35632 represents an open vascular bypass in which a synthetic graft is used to reroute flow from the iliac artery around an occluded celiac artery. This procedure addresses significant mesenteric or foregut ischemia caused by celiac trunk obstruction and is a specialized vascular surgery performed in hospital operating rooms or major ambulatory surgical centers. Nationally, CPT 35632 is relevant for tertiary vascular centers and programs managing complex visceral arterial disease because it involves major arterial reconstruction and impacts resource use, perioperative risk stratification, and post-operative monitoring.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication summarizes clinical context for the procedure, payer coverage patterns where available, and coding considerations relevant to hospital billing and surgical services. Readers will learn the clinical indication and service setting for CPT 35632, typical billing and documentation touchpoints, common modifiers listed in payer materials, and what information is not available in the input. This overview is intended for coding professionals, billing managers, and clinical leaders seeking a concise reference to the procedure represented by CPT 35632 and its role in managing celiac artery occlusion.

Customize your policy alerts

Sign up for cpt 35632 policy alerts

Get alerted when payer policies referencing 35632 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Billing Code Overview

CPT code 35632 describes a surgical bypass using a synthetic graft to reroute blood flow from the iliac artery around an occluded segment of the celiac artery. The procedure restores perfusion to the foregut circulation by creating an alternative arterial conduit.

Service type: Open vascular bypass using synthetic graft

Typical site of service: Hospital operating room or major ambulatory surgical center for vascular surgery, where open arterial reconstruction and graft placement are performed.

Find policies, billing codes, payers, states, and providers

CPT 35632: Iliac-to-Celiac Synthetic Graft Bypass

Customize your policy alerts

Sign up for cpt 35632 policy alerts

Get alerted when payer policies referencing 35632 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Billing Code Overview

Service type: Open vascular bypass using synthetic graft

Typical site of service: Hospital operating room or major ambulatory surgical center for vascular surgery, where open arterial reconstruction and graft placement are performed.

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.

Coding Specifications

Modifier	Description	When to Use
`00`	Default/No modifier	Used when no other modifier applies to the service.
`11`	Primary surgeon	Appended when the reporting surgeon was the primary surgeon who performed the majority of the procedure.
`22`	Increased procedural services	Used when the procedure required substantially greater work than typical (document reasons such as extensive dissection or unexpected complexity).
`52`	Reduced services	Used when the procedure was partially reduced or not completed as described (document the limitation).
`53`	Discontinued procedure	Applied when procedure was started but terminated due to extenuating circumstances (e.g., intraoperative instability).
`62`	Two surgeons	Used when two surgeons from different specialties work together as primary surgeons on distinct portions of the procedure.
`66`	Surgical team	Used when multiple surgeons are part of an organized surgical team performing the procedure.
`78`	Unplanned return to OR	Used for a return to the operating room for related treatment during the global period.
`80`	Assistant surgeon	Used when an assistant at surgery (qualified resident or physician) provides assistance.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery	Use when an APP assists at surgery and payer recognizes `AS` for assistant services.
`62`	Two surgeons	See above — used when two surgeons of different specialties provide distinct primary portions.

Taxonomy Code	Specialty	Notes
207RG0100X	Vascular Surgery	Primary specialty performing open arterial bypass procedures.
2080P0207X	General Surgery	General surgeons with vascular expertise may perform mesenteric bypass in some centers.
2084P0800X	Cardiothoracic-Vascular Surgery	Surgeons trained in thoracoabdominal vascular procedures that include visceral revascularization.
2085R0203X	Interventional Radiology	Provides preoperative or intraoperative angiography and endovascular alternatives; not typically performing open bypass.
207K00000X	Physician Assistant	APPs commonly assist perioperatively and may be reported with appropriate assistant modifiers.

Note: The table lists common provider taxonomies for clinicians involved in planning, performing, or assisting with an iliac-to-celiac artery synthetic graft bypass.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I77.4`	Stricture of artery	Represents focal arterial narrowing that may necessitate bypass when endovascular options are unsuitable.
`I70.2`	Atherosclerosis of native arteries of the extremities (nonvisceral)	Atherosclerotic disease commonly coexists and indicates systemic atherosclerosis; relevant to graft planning and graft conduit selection.
`K55.1`	Chronic mesenteric ischemia	Primary clinical indication for celiac revascularization when symptomatic and due to occlusive disease.
`I74.3`	Embolism and thrombosis of arteries of the lower extremity (visceral emboli codes less specific)	Thrombotic or embolic occlusion of visceral arteries may prompt bypass if acute or chronic and unsuitable for endovascular therapy.
`K76.9`	Liver disease, unspecified	Included to represent potential hepatic ischemia risk when celiac perfusion is compromised; may affect surgical risk assessment.
`Z95.2`	Presence of prosthetic heart valve	Example of comorbidity that may influence perioperative anticoagulation planning (illustrative comorbidity).

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`35632`	Bypass graft, with other than venous conduit, from iliac artery to celiac artery; with synthetic graft	Primary procedure: open extra-anatomic bypass using a synthetic graft to revascularize the celiac artery.
`36245`	Selective catheter placement, celiac trunk, with angiography	Often performed preoperatively or intraoperatively to define celiac anatomy and confirm distal runoff.
`36147`	Introduction of needle and/or catheter for diagnostic angiography, visceral artery	Used for diagnostic visceral angiography when assessing mesenteric circulation preoperatively.
`75952`	Percutaneous transluminal angioplasty, percutaneous, including radiological supervision and interpretation; each vessel	May be attempted as an endovascular alternative or adjunct to open bypass when anatomy permits.
`34820`	Repair, 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.
`93975`	Duplex 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.

CPT 35600: Arterial Graft Harvest from Arm 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 Using 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: Axillofemoral Bypass Using Synthetic Graft

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

CPT 35623: Axillary-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: Aortic-to-Visceral/Renal Bypass with Synthetic Graft

Showing 1–10 of 27

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`00`	Default/No modifier	Used when no other modifier applies to the service.
`11`	Primary surgeon	Appended when the reporting surgeon was the primary surgeon who performed the majority of the procedure.
`22`	Increased procedural services	Used when the procedure required substantially greater work than typical (document reasons such as extensive dissection or unexpected complexity).
`52`	Reduced services	Used when the procedure was partially reduced or not completed as described (document the limitation).
`53`	Discontinued procedure	Applied when procedure was started but terminated due to extenuating circumstances (e.g., intraoperative instability).
`62`	Two surgeons	Used when two surgeons from different specialties work together as primary surgeons on distinct portions of the procedure.
`66`	Surgical team	Used when multiple surgeons are part of an organized surgical team performing the procedure.
`78`	Unplanned return to OR	Used for a return to the operating room for related treatment during the global period.
`80`	Assistant surgeon	Used when an assistant at surgery (qualified resident or physician) provides assistance.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery	Use when an APP assists at surgery and payer recognizes `AS` for assistant services.
`62`	Two surgeons	See above — used when two surgeons of different specialties provide distinct primary portions.

Taxonomy Code	Specialty	Notes
207RG0100X	Vascular Surgery	Primary specialty performing open arterial bypass procedures.
2080P0207X	General Surgery	General surgeons with vascular expertise may perform mesenteric bypass in some centers.
2084P0800X	Cardiothoracic-Vascular Surgery	Surgeons trained in thoracoabdominal vascular procedures that include visceral revascularization.
2085R0203X	Interventional Radiology	Provides preoperative or intraoperative angiography and endovascular alternatives; not typically performing open bypass.
207K00000X	Physician Assistant	APPs commonly assist perioperatively and may be reported with appropriate assistant modifiers.

Note: The table lists common provider taxonomies for clinicians involved in planning, performing, or assisting with an iliac-to-celiac artery synthetic graft bypass.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I77.4`	Stricture of artery	Represents focal arterial narrowing that may necessitate bypass when endovascular options are unsuitable.
`I70.2`	Atherosclerosis of native arteries of the extremities (nonvisceral)	Atherosclerotic disease commonly coexists and indicates systemic atherosclerosis; relevant to graft planning and graft conduit selection.
`K55.1`	Chronic mesenteric ischemia	Primary clinical indication for celiac revascularization when symptomatic and due to occlusive disease.
`I74.3`	Embolism and thrombosis of arteries of the lower extremity (visceral emboli codes less specific)	Thrombotic or embolic occlusion of visceral arteries may prompt bypass if acute or chronic and unsuitable for endovascular therapy.
`K76.9`	Liver disease, unspecified	Included to represent potential hepatic ischemia risk when celiac perfusion is compromised; may affect surgical risk assessment.
`Z95.2`	Presence of prosthetic heart valve	Example of comorbidity that may influence perioperative anticoagulation planning (illustrative comorbidity).

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`35632`	Bypass graft, with other than venous conduit, from iliac artery to celiac artery; with synthetic graft	Primary procedure: open extra-anatomic bypass using a synthetic graft to revascularize the celiac artery.
`36245`	Selective catheter placement, celiac trunk, with angiography	Often performed preoperatively or intraoperatively to define celiac anatomy and confirm distal runoff.
`36147`	Introduction of needle and/or catheter for diagnostic angiography, visceral artery	Used for diagnostic visceral angiography when assessing mesenteric circulation preoperatively.
`75952`	Percutaneous transluminal angioplasty, percutaneous, including radiological supervision and interpretation; each vessel	May be attempted as an endovascular alternative or adjunct to open bypass when anatomy permits.
`34820`	Repair, 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.
`93975`	Duplex 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.

CPT 35600: Arterial Graft Harvest from Arm 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 Using 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: Axillofemoral Bypass Using Synthetic Graft

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

CPT 35623: Axillary-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: Aortic-to-Visceral/Renal Bypass with Synthetic Graft

Showing 1–10 of 27

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

CPT 35632: Iliac-to-Celiac Synthetic Graft Bypass

Sign up for cpt 35632 policy alerts

Billing Code Overview

Catch payer policy changes before they impact reimbursement

Catch payer policy changes before they impact reimbursement

OpenPayer

CPT 35632: Iliac-to-Celiac Synthetic Graft Bypass

Sign up for cpt 35632 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References