CPT 35907 Excision Infected Abdominal Graft Reimbursement | OpenPayer

Summary & Overview

CPT 35907: Excision of Infected Abdominal Graft

CPT code 35907 denotes the surgical excision of a previously placed abdominal graft that has become infected, including removal of infected tissue, dissection around vessels, layered repair, and possible placement of a drainage catheter. This code captures a complex operative intervention that intersects surgical, infectious disease, and wound-care management and is relevant nationally due to its implications for inpatient surgical resource use, postoperative infection control, and device-related complications.

Key payers commonly involved in coverage and payment for this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for the procedure, typical sites of service, and common procedural considerations. The publication outlines expected service line placement, common modifier usage (listed separately), and how payers characterize coverage for infected graft explantation.

This summary equips clinicians, billing professionals, and policy analysts with a clear understanding of what CPT code 35907 represents, why correct coding matters for care coordination and payment, and what to expect in terms of clinical and administrative workflow. Data not available in the input will be identified in the detailed sections that follow.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 35907graft explantationinfected graftsurgical excisionabdominal surgerywound drainageoperative codingvascular graft

Billing Code Overview

CPT code 35907 describes surgical excision of a previously placed abdominal graft that has become infected. The procedure involves accessing the graft by excising the overlying skin and deeper soft tissues, dissecting around the graft and associated vessels as needed, removing infected graft material and devitalized tissue, and repairing the site with layered sutures. The surgeon may also place a catheter for postoperative drainage at the wound site.

Service type: Surgical excision and debridement of infected implanted graft material
Typical site of service: Operating room or major ambulatory surgical facility with potential postoperative wound drainage management

Clinical & Coding Specifications

Clinical Context

A typical patient is a 58-year-old with a prior open abdominal aortic aneurysm repair who presents with fever, localized abdominal wall erythema, drainage from the graft incision site, and positive wound cultures. Imaging (CT angiography) demonstrates perigraft fluid and concern for graft infection. The vascular surgery team evaluates the patient, confirms systemic infection risk, and plans operative removal of the infected abdominal graft under general anesthesia. In the operating room the surgeon reopens the previous abdominal incision, dissects through skin, subcutaneous tissue, and fascia to expose the graft, controls and clamps proximal and distal vessels as needed, excises the infected prosthetic graft material and devitalized surrounding tissue, irrigates the field, places layered closure of the abdominal wall, and may leave a drain or place a catheter for wound management. The clinical workflow includes preoperative optimization (laboratory testing, blood cultures, broad-spectrum antibiotics), intraoperative documentation of graft removal, vessel control/clamping, extent of debridement, and placement of drains, and postoperative antimicrobial therapy with wound surveillance. Typical site of service is the inpatient hospital operating room; the service type is major vascular surgery with possible intensive postoperative care.

Coding Specifications

Modifier	Description	When to Use
`11`	Normal, uncomplicated procedure	Use when the procedure is the primary service and performed without unusual circumstances.

CPT 35875: Removal of Clot from Non-Hemodialysis Vascular Graft

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

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

CPT-35901-NECK-VASCULAR-GRAFT-REMOVAL-INFECTION

CPT 35901: Removal of Infected Neck Vascular Graft

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

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

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

CPT 35800: Neck Exploration for Bleeding, Clot, or Infection

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

CPT 35703: Exploratory Lower-Extremity Arterial Procedure Without Repair

CPT-35870-GRAFT-ENTERIC-FISTULA-REPAIR

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

CPT-35905-EXCISION-INFECTED-THORACIC-GRAFT

CPT 35905: Excision of Infected Thoracic Graft

CPT-35883-FEMORAL-GRAFT-REVISION-PATCH-GRAFT

CPT 35883: Open Femoral Patch Graft Revision of Synthetic Bypass

CPT-35700-ARTERIAL-BYPASS-GRAFT-REOPERATION

CPT 35700: Reoperation on Arterial Bypass Graft

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Taxonomy Code	Specialty	Notes
208000000X	Vascular Surgery	Primary specialty performing graft excision and vascular control.
207R00000X	General Surgery	Frequently assists with complex abdominal wall exposure and closure.
208100000X	Thoracic and Cardiac Surgery	May be involved if proximal aortic graft elements require cardiac/vascular expertise.
363A00000X	Infectious Disease	Consulted for perioperative and long-term antimicrobial management.
207L00000X	Surgical Critical Care	Manages complex postoperative ICU care when needed.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`T82.7`	Infection and inflammatory reaction due to other cardiac and vascular prosthetic devices, implants and grafts	Captures prosthetic vascular graft infection requiring excision.
`T82.89`	Other complications of cardiac and vascular prosthetic devices, implants and grafts	Used for other device-related complications when infection coding is not specific.
`I77.9`	Disorder of arteries and arterioles, unspecified	General vascular disorder code sometimes used as adjunct when site-specific code not available.
`K71.6`	Toxic liver disease with hepatitis, unspecified	Data not directly related; Data not available in the input.
`A41.9`	Sepsis, unspecified organism	Used when systemic infection or sepsis accompanies graft infection and impacts management.
`L03.90`	Cellulitis, unspecified site	Used when adjacent skin and soft-tissue infection or cellulitis is present at the graft site.
`T81.4`	Infection following a procedure	Used for postoperative wound or graft-related infections following prior surgery.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`32505`	Excision, mediastinal tumor, via thoracotomy or median sternotomy; complicated (e.g., requires cardiopulmonary bypass)	May be relevant if infected graft involves thoracoabdominal or mediastinal components requiring extended thoracic exposure.
`34833`	Removal and replacement, vascular prosthesis, abdominal aorta and bifurcation (e.g., for infection)	Performed when graft removal is followed by immediate in-line replacement during the same operation.
`35866`	Revision or repair of arteriovenous prosthetic graft, including thrombectomy and replacement	Related procedure type when managing infected vascular prostheses in other anatomic locations; demonstrates principles of graft excision and replacement.
`10180`	Incision and drainage, complex, postoperative wound infection (e.g., subcutaneous/intramuscular)	May be used for less extensive wound management or staged I&D procedures prior to or after graft excision.
`97602`	Removal of devitalized tissue from wounds; selective debridement, without anesthesia (e.g., sharps)	May be used for serial bedside debridements of wound margins as part of staged management after graft removal.
`36010`	Introduction of needle or catheter into vessel, not otherwise specified (e.g., for vascular access)	Relevant for intraoperative vascular access, catheter drainage placement, or postoperative interventions.

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