Summary & Overview
CPT 35884: Femoral Arterial Bypass Graft Patch Graft Revision
CPT code 35884 represents a vascular surgical revision in which an autologous vein patch is applied to revise the femoral anastomosis of a synthetic arterial bypass graft. This procedure is clinically significant for limb salvage and graft patency, and it is commonly performed in hospital operating rooms and inpatient vascular surgery settings. Nationally, procedures that restore graft function impact surgical outcomes, readmission risk, and downstream vascular care utilization.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a concise overview of clinical context, coding specifics, and payer coverage considerations. Readers will find benchmarks for utilization and payment where available, a summary of relevant policy and coverage themes, and clinical context for when this revision procedure is typically used. The content is intended to inform billing, coding, and policy stakeholders about how CPT code 35884 is described, where it is typically performed, and which major national payers are relevant to coverage and reimbursement discussions.
Data not available in the input for detailed payer-specific rates, associated taxonomies, ICD-10 diagnoses, and related CPT codes are noted where applicable.
Billing Code Overview
CPT code 35884 describes the surgical procedure in which the provider applies a patch graft made from the patient’s vein to revise the femoral connection of a synthetic arterial bypass graft. The procedure is performed to restore or improve the arterial anastomosis between a synthetic graft and the femoral artery using an autologous vein patch.
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Service type: Vascular surgical revision of graft anastomosis using autologous vein patch
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Typical site of service: Hospital operating room or inpatient vascular surgery setting
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with a prior synthetic femoral–popliteal arterial bypass presents with progressive rest pain and loss of distal pulses due to failure at the femoral anastomosis. Diagnostic angiography confirms anastomotic stenosis with patchable defect of the synthetic graft–native artery junction. The vascular surgeon harvests an autologous vein conduit (typically ipsilateral greater saphenous vein), prepares a vein patch graft, and reopens the femoral anastomosis to sew the vein patch onto the native femoral artery to revise and enlarge the connection to the existing synthetic bypass. The typical clinical workflow includes preoperative assessment and imaging (duplex ultrasound and/or CT angiography), pre-op consent and marking of the vein harvest site, operative debridement of the anastomosis, application of the autologous vein patch graft, hemostasis, wound closure, and postoperative monitoring for graft patency and limb perfusion. This procedure is performed in an operating room or vascular suite with general, regional, or monitored anesthesia care and is commonly performed by a vascular surgeon or a cardiovascular-thoracic surgeon with vascular training.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the work, time, and intensity are substantially greater than usual for 35884 due to extensive scar tissue or complex revision. |