2025 CPT code 35226
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Surgery Feed
Repair of a damaged blood vessel in the lower extremity without the use of a graft.
Modifiers may be applicable depending on the circumstances of the procedure.Consult the CPT manual and your payer's guidelines for specific modifier usage instructions. Common modifiers that may apply include, but are not limited to, 51, 59, 78, 79.
Medical necessity for 35226 is established by the presence of an injured or abnormal blood vessel in the lower extremity that compromises blood flow, requiring surgical repair to restore adequate perfusion. Documentation must clearly support the need for the intervention and its clinical justification.
The clinical responsibility includes pre-operative preparation, surgical intervention (including incision, dissection, hemostasis, vascular repair, and wound closure), and post-operative monitoring of blood flow to ensure the successful restoration of circulation.Anesthesia is generally included, unless provided by a separate provider.
In simple words: The doctor fixes a damaged blood vessel in your leg or foot without using any extra material. They'll make a small cut, repair the vessel with stitches, and make sure the blood flows normally again before closing the wound.
This CPT code, 35226, encompasses the direct repair of an injured or abnormal blood vessel located in a lower extremity.The procedure involves accessing the vessel through an incision, dissecting surrounding tissue, controlling bleeding, and repairing the vessel using sutures or ligation.Post-repair, the surgeon assesses blood flow using methods like Doppler ultrasound to confirm restoration of normal circulation. Wound irrigation and layered closure complete the procedure.This code excludes procedures involving vein grafts or other graft materials. For those, please refer to codes 35256 and 35286 respectively.
Example 1: A 65-year-old male presents with a lower extremity arterial injury following a motor vehicle accident.The surgeon performs a direct repair of the femoral artery using 35226. Post-operatively, the patient exhibits normal blood flow with palpable distal pulses., A 72-year-old female experiences a spontaneous rupture of a popliteal artery aneurysm.The surgeon performs an emergency repair utilizing 35226.Careful hemostasis and meticulous wound closure are paramount., A 50-year-old male with peripheral vascular disease undergoes surgical repair of a superficial femoral artery stenosis using 35226. Doppler studies confirm patency and adequate flow post-intervention.
* Preoperative assessment including patient history, physical exam, and relevant imaging (angiography, ultrasound).* Intraoperative notes detailing the surgical approach, type of repair (sutures, ligation), control of bleeding, and assessment of blood flow using Doppler.* Postoperative notes documenting the patient's condition, blood flow assessment, and any complications.* Relevant imaging studies performed before, during, and after the procedure.
** Always verify the correct code selection based on the specific details of the procedure performed.Consult with a qualified medical coding specialist for assistance if needed. This information is for guidance only and should not be considered exhaustive. It is crucial to stay updated on the most current coding guidelines.
- Revenue Code: P2F (MAJOR PROCEDURE, CARDIOVASCULAR - OTHER)
- RVU: The RVUs for this code will vary depending on geographic location, facility type, and other factors. Consult the CMS website and your specific payer's fee schedule for the most up-to-date information.
- Global Days: The global period for this procedure is not specified in the provided information and may vary according to payer guidelines and the complexity of the case.This should be determined by referring to specific payer guidelines.
- Payment Status: Active
- Modifier TC rule: A Technical Component (TC) modifier may apply if applicable based on the specifics of the situation.Refer to the current CPT manual and payer guidelines for further explanation.
- Fee Schedule: Historical fee schedule data is not provided in the source.Consult the AMA's CPT codebook, your payer's fee schedule, and other relevant billing resources for historical information.
- Specialties:Vascular Surgery, General Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center