Summary & Overview
CPT 35700: Reoperation on Arterial Bypass Graft
CPT code 35700 captures surgical reoperation on an arterial bypass graft performed more than one month after the initial graft placement to relieve a stricture or to replace a failing graft that circumvents an obstructed arterial segment. Nationally, this code is important for tracking complex vascular surgical care, postoperative complications requiring reintervention, and resource use associated with graft salvage or replacement. Common settings include hospital operating rooms and inpatient vascular surgery services.
Key payers included in this review are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of what the code represents, clinical context for when reoperation is reported, and the payer landscape relevant to coverage and billing practice. The analysis also presents benchmarks and policy considerations tied to surgical reintervention, coding clarity for reporting the additional technical effort of graft reaccess and repair, and implications for utilization monitoring. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 35700 describes a surgical reoperation on an arterial bypass graft performed more than one month after the original graft placement. The procedure addresses a graft stricture or replaces a failing graft that bypasses a diseased or obstructed arterial segment. This service reflects the additional work required to reaccess and repair or replace an existing arterial bypass graft.
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Service type: Surgical reoperation on arterial bypass graft
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Typical site of service: Hospital operating room or inpatient surgical setting
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with a prior femoropopliteal arterial bypass performed 14 months earlier presents with progressive claudication and a Doppler ultrasound showing high-grade stenosis of the bypass graft anastomosis. After noninvasive evaluation and duplex-confirmed graft stricture, the vascular surgeon schedules a reoperation to surgically revise and reaccess the bypass graft to restore patency. The procedure requires reentry into the previous operative field, control of the vessel and graft, removal of the stenotic segment, and either patch angioplasty or graft segment replacement. Intraoperative events include exposure of the graft, assessment of inflow and outflow, possible thrombectomy if thrombus is present, and placement of a new graft segment or revision of the anastomosis. Postoperative workflow includes monitoring in a recovery unit, vascular exam documentation, Doppler signals assessment, pain control, and instructions for anticoagulation or antiplatelet therapy as indicated. Coding uses 35700 to report the additional operative work to reaccess and repair or replace the arterial bypass graft more than one month after the initial placement.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | When work or time substantially exceeds usual for 35700 due to extensive dissection or unexpected complexity |