CPT 35901 Neck Vascular Graft Removal Reimbursement | OpenPayer

Summary & Overview

CPT 35901: Removal of Infected Neck Vascular Graft

CPT code 35901 denotes the surgical removal of an infected vascular graft in the neck and is used to report explantation of prosthetic vascular conduits when infection necessitates operative management. The code is clinically significant because infected vascular grafts carry high morbidity and resource needs, often requiring definitive surgical intervention, antimicrobial therapy, and inpatient care. National payers evaluate such procedures for clinical necessity, complication management, and appropriate site-of-service billing. Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will find a concise overview of the clinical context for 35901, common care settings and resource implications, and the types of benchmarks and policy considerations that affect payment and utilization. The publication summarizes coverage factors payers commonly assess, typical coding considerations tied to surgical explantation for infection, and areas where policy updates and prior authorization rules may influence authorization and reimbursement workflows. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 35901vascular graft removalgraft explantationsurgical procedureinfected vascular graftoperative managementneck surgeryinpatient surgeryvascular surgery

Billing Code Overview

CPT code 35901 describes the surgical removal of an infected vascular graft located in the neck. This procedure involves explantation of a prosthetic or synthetic vascular conduit that has become infected and requires operative removal.

Service type: Surgical procedure — graft explantation
Typical site of service: Operating room or other inpatient surgical setting

Clinical & Coding Specifications

Clinical Context

A 62-year-old male with end-stage renal disease presents with fever, erythema, and purulent drainage at a tunneled neck vascular graft site placed for hemodialysis access. Blood cultures are positive and imaging (neck ultrasound/CT) demonstrates surrounding fluid and graft involvement consistent with graft infection. The vascular surgeon evaluates the patient, discusses risks and alternatives, and documents the need for removal of the infected graft. The procedure is performed in an operating room under general anesthesia with surgical removal of the infected prosthetic graft from the neck, irrigation, debridement of infected tissue, and hemostasis. Postoperative care includes wound management, IV antibiotics guided by microbiology, monitoring for bleeding or vascular compromise, and planning for alternative dialysis access (e.g., new tunneled catheter or creation of an arteriovenous fistula) once infection is controlled.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier applicable (placeholder)	Rarely used; not standard on claims—use applicable modifier instead when none of the specific modifiers apply.
`11`	Performance of the procedure by the primary surgeon

CPT 35884: Femoral Arterial Bypass Graft Patch Graft Revision

CPT-35879-LOWER-EXTREMITY-BYPASS-GRAFT-VENOUS-PATCH

CPT 35879: Lower Extremity Bypass Graft Repair with Venous Patch

CPT-35700-ARTERIAL-BYPASS-GRAFT-REOPERATION

CPT 35700: Reoperation on Arterial Bypass Graft

CPT-35870-GRAFT-ENTERIC-FISTULA-REPAIR

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

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

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

CPT-35903-EXCISION-INFECTED-ARM-LEG-GRAFT

CPT 35903: Excision of Infected Arm or Leg Graft

CPT-35905-EXCISION-INFECTED-THORACIC-GRAFT

CPT 35905: Excision of Infected Thoracic Graft

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

CPT 35703: Exploratory Lower-Extremity Arterial Procedure Without Repair

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

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

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

CPT 35701: Neck Artery Exploration and Scar Tissue Removal

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Taxonomy Code	Specialty	Notes
`2080S0004X`	Vascular Surgery	Primary specialty performing graft removal and infected vascular access management.
`207K00000X`	Interventional Cardiology	May perform tunneled access management or endovascular components in some centers.
`207L00000X`	Cardiothoracic Surgery	Involvement when complex neck or central vascular reconstruction is required.
`208000000X`	General Surgery	Performs vascular graft removal in some hospitals, particularly trauma or infection cases.
`208000000X`	Nephrology (proceduralists within surgical teams)	Involved in planning dialysis access replacement; taxonomy shown for care coordination.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`T82.7XXA`	Infection and inflammatory reaction due to other vascular prosthetic devices, implants and grafts, initial encounter	Directly indicates infection of a vascular graft and is commonly used to justify graft removal.
`I77.1`	Stricture of artery	May be associated with graft dysfunction leading to interventions; less direct but relevant in vascular access pathology.
`T82.0XXA`	Mechanical complication of vascular prosthetic device, initial encounter	Documents mechanical failure or dysfunction of the graft requiring removal.
`L03.119`	Cellulitis of unspecified site, initial encounter	Describes overlying soft tissue infection that may accompany an infected graft in the neck.
`A41.9`	Sepsis, unspecified organism	Used when systemic infection (bacteremia/sepsis) is present in association with infected graft requiring removal.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36460`	Insertion of tunneled centrally inserted central venous catheter, with subcutaneous port or cuff, for dialysis	Often performed after graft removal to restore dialysis access when immediate access is needed.
`36831`	Thrombolysis, dialysis access graft, mechanical (with or without infusion)	Performed when graft thrombosis is present and salvage is attempted prior to or instead of removal.
`10160`	Incision and drainage of infected subcutaneous tissue, simple or single	May be performed for localized superficial infection adjacent to the graft as an adjunct.
`59909`	Removal of indwelling vascular access device (not elsewhere specified)	Alternative coding for nonstandard device removals depending on device characteristics and payer guidance.
`11044`	Debridement, muscle and/or fascia and/or bone (e.g., extensive debridement)	Used when extensive infected tissue debridement is required in addition to graft removal.

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