2025 CPT code 35256
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Surgery Feed
Repair of a lower extremity blood vessel using a vein graft.
Modifiers may be applicable depending on the specific circumstances of the procedure (e.g., 51 for multiple procedures, 59 for distinct procedural services, 22 for increased procedural services). Refer to CPT and payer guidelines.
Medical necessity is established by documented evidence of compromised blood flow in the lower extremity, leading to symptoms such as critical limb ischemia, claudication, or acute limb threat. Pre-operative imaging is necessary to confirm the diagnosis and location of the blockage.
The surgeon is responsible for all aspects of the procedure, including pre-operative planning, incision, dissection, graft harvest (if needed), anastomosis, hemostasis, and wound closure. Post-operative care may be included in the global surgical package or billed separately depending on payer rules.
In simple words: The doctor repairs a damaged blood vessel in your leg using a piece of vein from elsewhere in your body. This involves making incisions, carefully working around tissues and blood vessels, sewing the vein graft in, and checking that blood flows normally.
This CPT code encompasses the surgical repair of an abnormal or injured blood vessel in a lower extremity using a vein graft.The procedure involves accessing the vessel through an incision, dissecting surrounding tissue, controlling bleeding, harvesting a vein graft (if necessary), clamping the damaged vessel, suturing the graft into place, and verifying proper blood flow (e.g., using Doppler ultrasound). The incision is then closed.
Example 1: A patient presents with a significant blockage in the popliteal artery, causing critical limb ischemia.The surgeon performs an endarterectomy and then repairs the defect with a saphenous vein graft using CPT code 35256. , A patient experiences a traumatic injury to the femoral artery, resulting in significant blood loss. After emergency stabilization, the surgeon repairs the artery using an autologous vein graft harvested from the patient's saphenous vein, using CPT code 35256., A patient has a diseased superficial femoral artery resulting in intermittent claudication.The surgeon performs an open surgical bypass using a harvested great saphenous vein graft. CPT 35256 accurately reflects the surgical repair of the femoral artery with a vein graft.
Complete operative notes detailing the approach, vessel repaired, type of graft used (autologous vein graft), length of graft, location of harvest site, and measurements of blood flow pre and post-repair.Pre-operative imaging (angiography), intraoperative images and post-operative imaging (Doppler ultrasound or angiography) demonstrating patency.Consent form.
** Always refer to the most up-to-date CPT codebook and payer guidelines for the most accurate coding and reimbursement information.
- Revenue Code: P2F (MAJOR PROCEDURE, CARDIOVASCULAR - OTHER)
- RVU: This information requires accessing a specific fee schedule and is not available from provided context.
- Global Days: The global period for this procedure needs to be determined by referring to the specific payer's guidelines or local coverage determination.It is likely to vary.
- Payment Status: Active
- Modifier TC rule: The application of a TC modifier is not applicable to this code.This is a complete procedure.
- Fee Schedule: Historical fee schedule data is not available in the provided information; consult payer-specific fee schedules.
- Specialties:Vascular Surgery, General Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center