2025 CPT code 35301
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Surgery Feed
Thromboendarterectomy of the carotid, vertebral, or subclavian artery, including patch graft if performed, via neck incision.
Modifiers may be applicable depending on the specific circumstances of the procedure. Consult the CPT manual for appropriate modifier usage.
Medical necessity is established by the presence of significant stenosis or occlusion of the carotid, vertebral, or subclavian artery causing symptoms of ischemia (e.g., TIA, stroke, claudication).Documentation should clearly link symptoms to the stenosis/occlusion and demonstrate that conservative management is inadequate.
The surgeon is responsible for all aspects of the procedure, including pre-operative planning, incision, thromboendarterectomy, graft placement (if necessary), closure, and post-operative care.
In simple words: The doctor removes blood clots and fatty deposits from a blocked artery in the neck.This is done through a cut in the neck. Sometimes, a small piece of vein or artificial material may be used to repair the artery.
This procedure involves surgical removal of thrombus and plaque from a carotid, vertebral, or subclavian artery through a neck incision.The surgeon may use a temporary vascular shunt to maintain blood flow. A vein graft may be harvested and used as a patch graft if necessary. The procedure includes the removal of the intima (inner lining) of the artery, restoring normal arterial diameter.The artery is then closed with sutures, and the incision is closed in layers after hemostasis is achieved.
Example 1: A 65-year-old male presents with symptoms of transient ischemic attack (TIA) and is found to have significant stenosis of the left internal carotid artery. A carotid thromboendarterectomy with patch angioplasty is performed., A 72-year-old female with a history of hypertension and hyperlipidemia experiences a stroke.Angiography reveals a significant thrombus in the right vertebral artery. A vertebral artery thromboendarterectomy is performed., A 58-year-old male presents with upper extremity claudication due to subclavian artery stenosis.A subclavian artery thromboendarterectomy is performed, and a portion of the saphenous vein is harvested and used as a patch.
Preoperative diagnostic studies (e.g., carotid ultrasound, CT angiography, MRI), operative report detailing the procedure, including the extent of plaque removal, use of a shunt or graft, and postoperative course.Pathology report if a biopsy was performed.
** This code is used for thromboendarterectomy of carotid, vertebral, and subclavian arteries.The use of a patch graft is included in the code.Harvesting of a vein graft, if done, is also included.
- Revenue Code: P2C (Major Procedure, Cardiovascular - Thromboendarterectomy)
- RVU: This information is not available in the provided text.RVUs vary by geographic location and payer.
- Global Days: The global period for this procedure will vary depending on payer and other factors; additional information is needed.
- Payment Status: Active
- Modifier TC rule: Information on TC modifier applicability is not available in the provided data.
- Fee Schedule: Historical fee schedule data is not available in the provided source. Consult fee schedules from relevant payers and years.
- Specialties:Vascular Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center