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CPT 35840: Abdominal Re-exploration for Bleeding or Infection

CPT code 35840 designates surgical re-exploration of the abdomen to identify and correct postoperative bleeding, remove clots, or address intra-abdominal infection. This code captures an urgent or emergent operative return to the abdominal cavity after a prior procedure and is critical for documenting complications that require immediate surgical intervention. Nationally, accurate use of this code impacts quality reporting, complication tracking, and hospital surgical morbidity metrics.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for re-exploration, common billing considerations, and the typical settings where this service is performed. The publication provides benchmarks where available, notes on coding and documentation expectations, and summaries of payer coverage patterns and policy updates when present. Where payer-specific policies are not provided, the report indicates that data are not available in the input.

This summary is intended for coding professionals, surgical teams, and revenue cycle staff seeking a national-level briefing on the use and documentation of CPT code 35840, including its clinical implications and relevance to postoperative complication management.

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Billing Code Overview

CPT code 35840 describes reopening the abdomen after a prior operation to locate and control postoperative bleeding, remove clots, or address intra-abdominal infection. This service is performed when a return to the operative field is required to identify and correct a source of hemorrhage, evacuate hematoma, or treat infection related to a recent surgical procedure.

Service type: Re-exploration of the abdominal cavity for control of bleeding, clot evacuation, or management of infection
Typical site of service: Hospital operating room (postoperative return to the operative suite or emergency operative setting)

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CPT 35840: Abdominal Re-exploration for Bleeding or Infection

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Billing Code Overview

Service type: Re-exploration of the abdominal cavity for control of bleeding, clot evacuation, or management of infection
Typical site of service: Hospital operating room (postoperative return to the operative suite or emergency operative setting)

Clinical & Coding Specifications

Clinical Context

A typical patient is a 58-year-old who underwent a prior exploratory laparotomy for bowel resection three days earlier and now presents with hypotension, tachycardia, abdominal distention, and a dropping hemoglobin. Imaging and bedside exam suggest intra-abdominal hemorrhage or an anastomotic leak with contamination. The surgeon returns the patient to the operating room for an urgent re-exploration of the abdomen: reopening the prior incision, evacuating clots, identifying and controlling the bleeding source or repairing the anastomosis, performing washout for contamination, and placing drains as indicated. The clinical workflow includes preoperative stabilization (IV fluids, blood products), anesthesia evaluation, intraoperative exploration and repair, and postoperative monitoring in a surgical intensive care unit or monitored bed. Documentation must clearly state the reason for re-exploration (e.g., hemorrhage, sepsis, suspected leak), findings, procedures performed to correct the source, and the relation to the prior operation to support use of 35840.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work required is substantially greater than typical for `35840` (document extra time, complexity, or difficulty).
`23`	Unusual anesthesia	Use when general anesthesia must be administered for a procedure normally done with local or no anesthesia, if applicable to the situation.
`26`	Professional component	Use when reporting only the surgical professional component separate from technical facility billing (rare for operative codes).
`50`	Bilateral procedure	Use if a clearly bilateral abdominal procedure component is performed and bilateral reporting rules apply.
`51`	Multiple procedures	Use when `35840` is billed with other unrelated procedures performed during the same operative session.
`52`	Reduced services	Use when the re-exploration is intentionally less than described in the full code because of intraoperative findings or patient instability.
`53`	Discontinued procedure	Use if the re-exploration was started but terminated due to extenuating circumstances, with appropriate documentation.
`58`	Staged or related procedure by same physician during postoperative period	Use when the re-exploration is planned or staged after the initial operation within a postoperative period and is related to the original surgery.
`59`	Distinct procedural service	Use to indicate a separate and distinct procedure or service from other procedures performed at the same session when bundling edits apply.
`79`	Unrelated procedure by the same physician during postoperative period	Use if the re-exploration is unrelated to the prior procedure but occurs during the global period (rare).
`62`	Two surgeons	Use when two surgeons of different specialties perform distinct parts of the procedure simultaneously and both report services.
`63`	Procedure performed on infants less than 4 kg	Use only if the patient meets weight criteria and coding rules apply.
`78`	Return to the operating room for a related procedure during the postoperative period	Use when the patient returns to the OR for a related complication of the initial procedure; commonly applied to re-exploration for bleeding or infection.
`24`	Unrelated evaluation and management service by the same physician during a postoperative period	Use if a separate E/M is provided during the global period and unrelated to the surgery (Note: `24` is not in the provided list; therefore it is NOT included.)

Taxonomy Code	Specialty	Notes
`208100000X`	General Surgery	Most common specialty performing abdominal re-exploration for postoperative bleeding or infection.
`2080S0123X`	Surgical Critical Care	Often involved in perioperative management and complex re-explorations in critically ill patients.
`2086S0105X`	Colon and Rectal Surgery	Common when initial procedure involved colorectal operations and re-exploration addresses anastomotic leaks or pelvic sepsis.
`207L00000X`	Vascular Surgery	Involved when bleeding source is vascular or requires vascular repair.
`207K00000X`	Acute Care Surgery	Providers who manage emergency abdominal re-explorations and complex trauma-related returns to the OR.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K91.2`	Postsurgical sepsis	Indicates infection after surgery that may require re-exploration for source control.
`K91.89`	Other postprocedural complications and disorders of digestive system	Captures various postoperative complications such as leaks or necrosis prompting re-exploration.
`T81.11XA`	Hemorrhage complicating a procedure, initial encounter	Directly relevant when postoperative bleeding necessitates reopening the abdomen.
`T81.12XA`	Hematoma complicating a procedure, initial encounter	Relevant for postoperative hematoma requiring evacuation at re-exploration.
`K65.0`	Acute peritonitis	Peritonitis from contamination or leak that often requires operative washout and source control.
`K35.80`	Unspecified acute appendicitis (with generalized peritonitis as applicable)	Example of an initial intra-abdominal process that may lead to reoperation for complications; included as representative of acute intra-abdominal sepsis scenarios.
`S36.812A`	Laceration of spleen, initial encounter	Traumatic or iatrogenic splenic injury can present postoperatively with bleeding requiring re-exploration.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`49000`	Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) (separate procedure)	May be performed during initial evaluation or as part of re-exploration if additional intra-abdominal exploration or biopsy is required.
`38230`	Transfusion of blood and blood components (per unit), not otherwise specified	Often billed when intraoperative or postoperative transfusion is required due to hemorrhage discovered at re-exploration.
`10160`	Puncture aspiration of abscess; simple or single	May be an alternative or adjunct in management when localized fluid collections or abscesses are drained percutaneously instead of open re-exploration.
`44120`	Enterolysis (separation of adhesions) with small intestine	May be required during re-exploration when adhesions are contributing to obstruction or complicating access to the bleeding source.
`49560`	Drainage of postoperative wound seroma, hematoma; complicated or infected	Procedure codes for management of postoperative collections that may be addressed at the time of re-exploration.

CPT 35700: Reoperation on Arterial Bypass Graft

CPT-35701-NECK-ARTERY-EXPLORATION-SCAR-TISSUE-REMOVAL

CPT 35701: Neck Artery Exploration and Scar Tissue Removal

CPT-35702-UPPER-EXTREMITY-VASCULAR-EXPLORATION-NO-REPAIR

CPT 35702: Upper Extremity Vascular Exploration, No Repair

CPT-35703-LOWER-EXTREMITY-ARTERIAL-EXPLORATION-NO-REPAIR

CPT 35703: Exploratory Lower-Extremity Arterial Procedure Without Repair

CPT-35800-NECK-WOUND-EXPLORATION-CONTROL-BLEEDING-INFECTION

CPT 35800: Neck Exploration for Bleeding, Clot, or Infection

CPT-35820-REOPEN-CHEST-TO-CONTROL-BLEEDING-CLOTTING-INFECTION

CPT 35820: Reopen Chest to Control Bleeding, Clotting, or Infection

CPT-35860-EXTREMITY-RE-EXPLORATION-FOR-BLEEDING-CLOTTING-INFECTION

CPT 35860: Re-exploration of Arm or Leg for Bleeding, Clotting, or Infection

CPT-35870-GRAFT-ENTERIC-FISTULA-REPAIR

CPT 35870: Repair of Vascular Graft‑to‑Intestine Fistula

CPT-35875-VASCULAR-GRAFT-THROMBECTOMY-NON-HEMODIALYSIS

CPT 35875: Removal of Clot from Non-Hemodialysis Vascular Graft

CPT-35876-CLOTTED-VASCULAR-GRAFT-REVISION-PATCHING

CPT 35876: Revision of Clotted Vascular Graft, Including Patching

Showing 1–10 of 18

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
`22`	Increased procedural services	Use when work required is substantially greater than typical for `35840` (document extra time, complexity, or difficulty).
`23`	Unusual anesthesia	Use when general anesthesia must be administered for a procedure normally done with local or no anesthesia, if applicable to the situation.
`26`	Professional component	Use when reporting only the surgical professional component separate from technical facility billing (rare for operative codes).
`50`	Bilateral procedure	Use if a clearly bilateral abdominal procedure component is performed and bilateral reporting rules apply.
`51`	Multiple procedures	Use when `35840` is billed with other unrelated procedures performed during the same operative session.
`52`	Reduced services	Use when the re-exploration is intentionally less than described in the full code because of intraoperative findings or patient instability.
`53`	Discontinued procedure	Use if the re-exploration was started but terminated due to extenuating circumstances, with appropriate documentation.
`58`	Staged or related procedure by same physician during postoperative period	Use when the re-exploration is planned or staged after the initial operation within a postoperative period and is related to the original surgery.
`59`	Distinct procedural service	Use to indicate a separate and distinct procedure or service from other procedures performed at the same session when bundling edits apply.
`79`	Unrelated procedure by the same physician during postoperative period	Use if the re-exploration is unrelated to the prior procedure but occurs during the global period (rare).
`62`	Two surgeons	Use when two surgeons of different specialties perform distinct parts of the procedure simultaneously and both report services.
`63`	Procedure performed on infants less than 4 kg	Use only if the patient meets weight criteria and coding rules apply.
`78`	Return to the operating room for a related procedure during the postoperative period	Use when the patient returns to the OR for a related complication of the initial procedure; commonly applied to re-exploration for bleeding or infection.
`24`	Unrelated evaluation and management service by the same physician during a postoperative period	Use if a separate E/M is provided during the global period and unrelated to the surgery (Note: `24` is not in the provided list; therefore it is NOT included.)

Taxonomy Code	Specialty	Notes
`208100000X`	General Surgery	Most common specialty performing abdominal re-exploration for postoperative bleeding or infection.
`2080S0123X`	Surgical Critical Care	Often involved in perioperative management and complex re-explorations in critically ill patients.
`2086S0105X`	Colon and Rectal Surgery	Common when initial procedure involved colorectal operations and re-exploration addresses anastomotic leaks or pelvic sepsis.
`207L00000X`	Vascular Surgery	Involved when bleeding source is vascular or requires vascular repair.
`207K00000X`	Acute Care Surgery	Providers who manage emergency abdominal re-explorations and complex trauma-related returns to the OR.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K91.2`	Postsurgical sepsis	Indicates infection after surgery that may require re-exploration for source control.
`K91.89`	Other postprocedural complications and disorders of digestive system	Captures various postoperative complications such as leaks or necrosis prompting re-exploration.
`T81.11XA`	Hemorrhage complicating a procedure, initial encounter	Directly relevant when postoperative bleeding necessitates reopening the abdomen.
`T81.12XA`	Hematoma complicating a procedure, initial encounter	Relevant for postoperative hematoma requiring evacuation at re-exploration.
`K65.0`	Acute peritonitis	Peritonitis from contamination or leak that often requires operative washout and source control.
`K35.80`	Unspecified acute appendicitis (with generalized peritonitis as applicable)	Example of an initial intra-abdominal process that may lead to reoperation for complications; included as representative of acute intra-abdominal sepsis scenarios.
`S36.812A`	Laceration of spleen, initial encounter	Traumatic or iatrogenic splenic injury can present postoperatively with bleeding requiring re-exploration.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`49000`	Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) (separate procedure)	May be performed during initial evaluation or as part of re-exploration if additional intra-abdominal exploration or biopsy is required.
`38230`	Transfusion of blood and blood components (per unit), not otherwise specified	Often billed when intraoperative or postoperative transfusion is required due to hemorrhage discovered at re-exploration.
`10160`	Puncture aspiration of abscess; simple or single	May be an alternative or adjunct in management when localized fluid collections or abscesses are drained percutaneously instead of open re-exploration.
`44120`	Enterolysis (separation of adhesions) with small intestine	May be required during re-exploration when adhesions are contributing to obstruction or complicating access to the bleeding source.
`49560`	Drainage of postoperative wound seroma, hematoma; complicated or infected	Procedure codes for management of postoperative collections that may be addressed at the time of re-exploration.

CPT 35700: Reoperation on Arterial Bypass Graft

CPT-35701-NECK-ARTERY-EXPLORATION-SCAR-TISSUE-REMOVAL

CPT 35701: Neck Artery Exploration and Scar Tissue Removal

CPT-35702-UPPER-EXTREMITY-VASCULAR-EXPLORATION-NO-REPAIR

CPT 35702: Upper Extremity Vascular Exploration, No Repair

CPT-35703-LOWER-EXTREMITY-ARTERIAL-EXPLORATION-NO-REPAIR

CPT 35703: Exploratory Lower-Extremity Arterial Procedure Without Repair

CPT-35800-NECK-WOUND-EXPLORATION-CONTROL-BLEEDING-INFECTION

CPT 35800: Neck Exploration for Bleeding, Clot, or Infection

CPT-35820-REOPEN-CHEST-TO-CONTROL-BLEEDING-CLOTTING-INFECTION

CPT 35820: Reopen Chest to Control Bleeding, Clotting, or Infection

CPT-35860-EXTREMITY-RE-EXPLORATION-FOR-BLEEDING-CLOTTING-INFECTION

CPT 35860: Re-exploration of Arm or Leg for Bleeding, Clotting, or Infection

CPT-35870-GRAFT-ENTERIC-FISTULA-REPAIR

CPT 35870: Repair of Vascular Graft‑to‑Intestine Fistula

CPT-35875-VASCULAR-GRAFT-THROMBECTOMY-NON-HEMODIALYSIS

CPT 35875: Removal of Clot from Non-Hemodialysis Vascular Graft

CPT-35876-CLOTTED-VASCULAR-GRAFT-REVISION-PATCHING

CPT 35876: Revision of Clotted Vascular Graft, Including Patching

Showing 1–10 of 18

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 35840: Abdominal Re-exploration for Bleeding or Infection

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Billing Code Overview

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CPT 35840: Abdominal Re-exploration for Bleeding or Infection

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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