CPT 35876 Reimbursement & Policy Benchmarks

CPT code 35876 represents surgical management of a clotted vascular graft (excluding hemodialysis grafts) with revision of the existing graft, for example by patching. This procedure is relevant for vascular surgeons and hospitals managing thrombosed prosthetic or autologous grafts, as timely revision can restore blood flow and prevent limb- or organ-threatening ischemia. Nationally, the code matters for accurate surgical reporting, claims adjudication, and tracking utilization of vascular revision procedures.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a concise view of billing and clinical context for CPT code 35876, including typical sites of service and the nature of the procedure. Readers will find benchmarks where available, policy and coverage considerations at major payers, coding and documentation notes, and the clinical circumstances that commonly prompt use of the code. Where input data is missing, the report states that specific details are not available.

The content is arranged to support clinicians, coding professionals, and policy analysts who need a national-level summary of the code's purpose, expected use, and payer landscape without making clinical recommendations.

Billing Code Overview

CPT code 35876 describes surgical treatment of a clotted vascular graft (other than one used for hemodialysis) with revision of the existing graft, such as by patching. The procedure involves restoring patency and revising the graft material to correct the underlying issue causing thrombosis.

Service type: Surgical vascular graft revision and thrombectomy
Typical site of service: Hospital operating room or inpatient surgical setting

Data not available in the input.

Clinical Context

A 68-year-old patient with a previously placed synthetic femoropopliteal bypass graft presents with acute limb ischemia characterized by worsening rest pain and diminished distal pulses. Duplex ultrasound and CTA confirm thrombosis of the prosthetic graft with limited native runoff. The vascular surgeon evaluates the patient in the hospital vascular clinic and determines the graft is salvageable with operative revision. In the operating room under general or regional anesthesia, the surgeon exposes the graft, performs thromboembolectomy as needed, revises the graft by patch angioplasty or excision and primary anastomotic repair, and restores flow. Postoperatively the patient is monitored on the vascular service for limb perfusion, anticoagulation management, and wound care prior to discharge.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when reporting only the physician’s professional service separate from technical hospital charges, if applicable.
`50`	Bilateral procedure	Use when identical graft revision procedures are performed bilaterally during the same operative session.

Taxonomy Code	Specialty	Notes
`207K00000X`	Vascular Surgery	Surgeons who most commonly perform graft thrombectomy and revision.
`207R00000X`	General Surgery	General surgeons with vascular training who perform peripheral graft revision.
`2080P0002X`	Thoracic and Cardiac Surgery	Cardio-thoracic/vascular surgeons involved when grafts are in central or chest vasculature.
`208000000X`	Family Medicine	Occasionally involved for initial presentation and perioperative care coordination.
`207L00000X`	Interventional Radiology	May perform pre- or post-operative imaging and endovascular interventions in coordination with surgical revision.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I74.3`	Embolism and thrombosis of arteries of lower extremities	Common cause of acute graft thrombosis and limb ischemia necessitating graft revision.
`I97.1`	Postprocedural disorders of circulatory system, not elsewhere classified	Used for complications related to prior vascular procedures including graft thrombosis.
`I70.2`	Atherosclerosis of native arteries of the extremities	Contributes to graft failure and influences decision-making for revision vs. alternate revascularization.
`T82.4XXA`	Mechanical complication of vascular prosthetic device, initial encounter	Applied when there is a complication of the synthetic graft such as thrombosis or structural failure.
`I74.9`	Arterial embolism and thrombosis, unspecified	Used when specific arterial location is not otherwise specified but thrombotic event requires intervention.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`37186`	Thrombolysis, infusion for acute limb ischemia (peripheral, catheter-directed)	May be performed before or instead of open graft revision to lyse thrombus within the graft or runoff vessels.
`35301`	Thrombectomy, open, arterial, other than carotid; with embolectomy, with or without patch angioplasty	Related open thrombectomy techniques that may be performed on native arteries or conduit during limb salvage.
`35701`	Revision, arterial graft; open, with declot and revision of an existing graft (other than dialysis)	Procedurally related open revision codes that describe declotting and revision of peripheral arterial grafts.
`35876`	Treatment of clotted vascular graft, other than hemodialysis, and revision of existing graft (such as patching)	Primary procedure for surgical declotting and revision of non-dialysis vascular grafts.
`36010`	Introduction of a catheter, vein; for diagnostic or therapeutic purposes	Access-related codes for catheter-based thrombolysis or angiography used adjunctively.

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Summary & Overview

CPT 35876: Revision of Clotted Vascular Graft, Including Patching