Summary & Overview
CPT 35875: Removal of Clot from Non-Hemodialysis Vascular Graft
CPT code 35875 identifies surgical removal of a clot from a vascular graft that is not used for hemodialysis. This procedure addresses graft thrombosis, a complication that can threaten limb perfusion or graft patency and often requires prompt operative intervention. Nationally, accurate coding of graft thrombectomy is important for clinical documentation, resource utilization tracking, and appropriate claims adjudication.
Key payers included in this overview are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The report covers how payers typically recognize and reimburse operative vascular procedures, considerations for site of service, and common clinical contexts in which the procedure is performed.
Readers will learn the clinical scope of the code, typical sites of service, and the payer landscape relevant to CPT code 35875. The material outlines the procedural role of graft thrombectomy in preserving graft function and limb viability, and summarizes what stakeholders should know about coding classification and payer coverage patterns at a national level. Data not available in the input is noted where applicable; the narrative focuses on core clinical and coding facts surrounding this code rather than local policy variations.
Billing Code Overview
CPT code 35875 describes a procedure in which the provider removes a clot from a vascular graft, other than one used for hemodialysis. This procedure is a vascular thrombectomy of a non-hemodialysis graft.
Service type: Operative vascular procedure
Typical site of service: Hospital operating room or inpatient surgical suite; may also occur in ambulatory surgical centers depending on clinical context and facility capabilities.
Clinical & Coding Specifications
Clinical Context
A patient with a synthetic or autologous vascular graft in an arterial or venous circuit (excluding hemodialysis access) presents with acute limb ischemia or graft dysfunction due to thrombotic occlusion. Typical presentation includes sudden onset pain, pallor, paresthesia, pulselessness, and reduced motor function in the affected limb or progressive loss of graft inflow/outflow with limb-threatening ischemia. Initial evaluation includes vascular exam, duplex ultrasound or CT angiography to confirm graft thrombosis, laboratory assessment including coagulation profile, and vascular surgery consultation. The procedure 35875 (thrombectomy — removal of clot from a vascular graft other than hemodialysis) is performed in an operating room or hybrid endovascular suite under regional or general anesthesia. The workflow commonly includes preoperative imaging review, anticoagulation management, surgical exposure of the graft, thrombectomy using Fogarty catheter or direct thrombectomy techniques, assessment of distal runoff, possible graft revision or patch angioplasty, completion angiography, and postoperative monitoring in a PACU or step-down unit. Typical payors for authorization and claims processing include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing separately for the surgeon or physician professional component if a technical component is billed by facility. |