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    OpenPayerBilling CodesRepair, Excision, Exploration, Revision Procedures on Arteries and VeinsCPT cpt-35903-excision-infected-arm-leg-graft
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    CPT 35903: Excision of Infected Arm or Leg Graft

    Medicare pays $521 on average nationally for this procedure.

    CPT code 35903 describes surgical excision of a previously placed arterial or venous graft in the arm or leg that has become infected; the service is a graft excision procedure performed in an operating room or other inpatient/outpatient surgical setting to remove the infected prosthetic or autologous conduit and control local infection.

    For related coverage guidance, see recent payer policy updates: Positron Emission Tomography (PET) - Non-Oncologic Applications, Positron Emission Tomography (PET) Oncologic Applications, Magnetic Resonance Imaging (MRI) of the Prostate.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is a middle-aged adult with a previously placed autogenous or prosthetic vascular graft in the upper or lower extremity who presents with signs of graft infection such as localized erythema, drainage, swelling, pain, systemic fever, or bacteremia. Preoperative evaluation includes history and physical, vascular imaging (duplex ultrasound, CT angiography) to assess graft integrity and distal perfusion, and laboratory studies including blood cultures and inflammatory markers. The surgical team performs explantation of the infected graft in an operating room under general or regional anesthesia. Intraoperative steps include proximal and distal vascular control, removal of the graft material, thorough debridement of infected tissue, irrigation, culture of graft and tissue, and assessment of limb perfusion. Depending on the clinical scenario, immediate or staged revascularization (eg, bypass using autologous conduit or prosthetic graft) may follow, or the limb may be managed with antibiotic therapy and delayed reconstruction. Typical sites of service are the hospital operating room or an ambulatory surgical center when clinically appropriate. Perioperative documentation should include the original graft type and location, indications for removal, operative findings, cultures obtained, hemostasis method, complications, estimated blood loss, and postoperative plan including antibiotics and follow-up vascular surgery or wound care visits.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    37182Transcatheter therapy, intravascular, open or percutaneous, for peripheral artery disease; with intraprocedural graft/stent placementUsed when endovascular revascularization or stent placement is performed after or instead of open graft replacement.
    35566Thrombectomy, open; extremity, arterial, with thromboendarterectomy when performedPerformed when an infected graft is thrombosed and thrombus removal is required in conjunction with graft excision.
    36831Revision, open, of arteriovenous dialysis access graft; with thrombectomy, if performedRelevant when the infected graft is an AV dialysis graft requiring excision and potential revision or new access creation.
    35666Thromboembolectomy, with or without lacing of artery (eg, Fogarty), for lower extremityPerformed when distal emboli or thrombosis require removal at the time of graft explantation.
    11043Debridement, including removal of devitalized tissue and/or foreign material, extensiveUsed when extensive soft-tissue debridement accompanies graft removal due to surrounding infection.
    99024Postoperative follow-up visit, related to surgery during global period, normally includedRepresents routine postoperative care; separate billing only when billing policies allow for unrelated services.

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207K00000XAllergy & Immunology PhysicianAn allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…
    207RG0300XGeriatric Medicine (Internal Medicine) PhysicianAn internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects o…
    208000000XPediatrics PhysicianA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    163WP1700XPerinatal Registered NurseNursing Service Providers · Registered Nurse
    111N00000XChiropractorA provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the hea…
    207RA0002XAdult Congenital Heart Disease PhysicianA physician who specializes in the care and treatment of adults with congenital heart disease. Adult congenital heart disease (ACHD) physicians are tr…
    251C00000XDevelopmentally Disabled Services Day Training AgencyThese agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of d…

    Related ICD-10-CM Codes

    24 rows

    ICD-10-CM CodeDescription
    A41.51Sepsis due to Escherichia coli [E. coli]
    A41.9Sepsis, unspecified organism
    B95.61Methicillin susceptible Staphylococcus aureus infection as the cause of diseases classified elsewhere
    B95.62Methicillin resistant Staphylococcus aureus infection as the cause of diseases classified elsewhere
    E86.0Dehydration
    I70.201Unspecified atherosclerosis of native arteries of extremities, right leg
    I70.231Atherosclerosis of native arteries of right leg with ulceration of thigh
    I70.241Atherosclerosis of native arteries of left leg with ulceration of thigh
    I80.3Phlebitis and thrombophlebitis of lower extremities, unspecified
    I87.2Venous insufficiency (chronic) (peripheral)

    Showing 1–10 of 24

    Related Payer Policy Updates

    Specialty: Radiology/Diagnostic Imaging1 / 2

    10 rows

    PolicyPayerEffective Date
    Positron Emission Tomography (PET) - Non-Oncologic Applicationsuniverahealthcare2026-10-15
    Positron Emission Tomography (PET) Oncologic Applicationsuniverahealthcare2026-10-15
    Magnetic Resonance Imaging (MRI) of the Prostateuniverahealthcare2026-10-15
    Pediatric and Special Populations Spine Imaging Guidelines (For Ohio Only)Colorado Rocky Mountain Health Plans2026-09-01
    Pediatric Chest Imaging Guidelines (Ohio) — Radiology Imaging Coverage Determination GuidelineColorado Rocky Mountain Health Plans2026-09-01
    Pediatric Neck Imaging Guidelines (Ohio)Colorado Rocky Mountain Health Plans2026-09-01
    Pediatric Peripheral Vascular Disease (PVD) Imaging Guidelines (Ohio)Colorado Rocky Mountain Health Plans2026-09-01
    Adult Head Imaging Guidelines (Ohio) — Radiology Imaging Coverage Determination GuidelineColorado Rocky Mountain Health Plans2026-09-01
    Adult Cardiac Imaging Guidelines (For Ohio Only)Colorado Rocky Mountain Health Plans2026-09-01
    Adult Spine Imaging Guidelines (Ohio) — Radiology Imaging Coverage Determination GuidelineColorado Rocky Mountain Health Plans2026-09-01

    Related Codes

    CPT-35700-ARTERIAL-BYPASS-GRAFT-REOPERATION

    CPT 35700: Reoperation on Arterial Bypass Graft

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

    CPT 35701: Exploration and Examination of Neck Artery

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

    CPT 35702: Exploration of Upper Extremity Arteries

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

    CPT 35703: Exploratory Operation on Lower Extremity Arteries, No Repair

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

    CPT 35800: Neck Re-exploration to Control Bleeding or Infection

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

    CPT 35820: Re-exploration of Chest for Bleeding/Clot/Infection

    CPT-35840-ABDOMINAL-RE-EXPLORATION-FOR-BLEEDING-OR-INFECTION

    CPT 35840: Exploratory Laparotomy for Postoperative Bleeding/Infection

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

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

    CPT-35870-GRAFT-ENTERIC-FISTULA-REPAIR

    CPT 35870: Repair of Vascular Graft–Enteric Fistula

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

    CPT 35875: Thrombectomy of Vascular Graft (non-hemodialysis)

    Showing 1–10 of 18

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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