2025 CPT code 34451
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Surgery Feed
Thrombectomy, direct or with catheter; vena cava, iliac, femoropopliteal vein, by abdominal and leg incision.
Modifiers may be applicable depending on the circumstances of the procedure (e.g., 51 for multiple procedures, 59 for distinct procedural service, 22 for increased procedural service, etc.).
Medical necessity is established by the presence of a significant venous thrombus that obstructs blood flow, causing symptoms (e.g., pain, swelling, ischemia) or posing a risk of life-threatening complications (e.g., pulmonary embolism).
The surgeon is responsible for performing the incision, identifying the clot location, placing vessel clips, incising the vessel to access the clot, excising the clot (potentially using a balloon catheter), repairing the vein, checking blood flow (e.g., with Doppler), and closing the incisions. Anesthesiologist involvement is also typical for this procedure.
In simple words: The doctor makes incisions in the abdomen and leg to reach a blood clot in a large vein. The clot is removed, either directly or using a thin tube, and the vein is repaired. The doctor then checks to make sure the blood flows normally.
This procedure involves a surgical approach via abdominal and leg incisions to access the vena cava, iliac veins, and/or femoropopliteal veins.A thrombus (blood clot) is removed either directly or with the assistance of a catheter. The surgical technique may include vessel incision, clot excision, and possible balloon catheter use to facilitate complete clot removal. Post-procedure, the vein is repaired, and the blood flow is assessed (e.g., using Doppler ultrasound) to ensure patency. The incisions are then closed in layers using sutures.
Example 1: A patient presents with acute deep vein thrombosis (DVT) in the iliac and femoropopliteal veins, causing significant leg swelling and pain.A thrombectomy is performed to remove the clot, restoring blood flow and alleviating symptoms., A patient with a history of recurrent DVT undergoes a thrombectomy of the inferior vena cava to prevent pulmonary embolism., During a lower extremity bypass surgery, a clot is discovered in the femoropopliteal vein.The surgeon performs an in situ thrombectomy as part of the bypass procedure.
* Preoperative assessment and diagnosis (e.g., Doppler ultrasound, venography).* Detailed operative report outlining surgical approach, technique used (direct or with catheter), clot location, size, and characteristics.* Description of any complications encountered and management strategies.* Postoperative assessment of blood flow (e.g., Doppler ultrasound).* Histopathological examination of the removed clot (if applicable).
** This code describes thrombectomy of specific veins.Use of a catheter is optional.Additional codes may be necessary for other procedures performed during the same surgical session.
- Revenue Code: P2F (Major Procedure, Cardiovascular - Other)
- RVU: Information not available in provided data.Consult the AMA CPT® codebook or other relevant resources for RVU data.
- Global Days : Information not available in provided data.Consult the AMA CPT® codebook or other relevant resources for global days information.
- Payment Status: Active
- Modifier TC rule: Information not available in provided data. Consult the AMA CPT® codebook for TC modifier rules.
- Fee Schedule : Information not provided. Consult fee schedules from relevant payers.
- Specialties:Vascular Surgery, General Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center