2025 CPT code 35501
(Active) Effective Date: N/A Revision Date: N/A Surgery - Vascular Procedures Surgery Feed
Bypass graft using a vein; common carotid artery to ipsilateral internal carotid artery.
Modifiers may be applicable depending on the circumstances of the procedure and the payer's requirements.Examples might include 51 (multiple procedures), 59 (distinct procedural service), or others, if multiple procedures or services are performed during the same operative session. Always consult current modifier guidelines and payer instructions.
Medical necessity is established by the presence of symptomatic or asymptomatic significant carotid artery stenosis or occlusion, posing a substantial risk of stroke.The procedure is indicated to improve blood flow to the brain and reduce the risk of ischemic events. Documentation must support the clinical indication, severity of stenosis, and the patient's risk factors to justify medical necessity.
The clinical responsibility involves the surgeon performing the bypass graft procedure, including pre-operative planning, meticulous dissection of the neck region to expose the carotid arteries, harvesting of the vein graft (if autologous), precise anastomosis of the graft to the common and internal carotid arteries, hemostasis, and wound closure.Postoperative care, including monitoring and follow-up, are generally considered part of the global period but may have separate billing implications depending on the payer.
In simple words: The doctor creates a detour around a blocked artery in your neck using a piece of vein taken from elsewhere in your body. This restores blood flow to your brain.
This CPT code 35501 describes a surgical procedure where a bypass graft, constructed from a vein, is used to reroute blood flow around a blockage in the carotid artery.The procedure involves connecting the common carotid artery to a segment of the internal carotid artery on the same side of the neck (ipsilateral). This restores blood flow to the brain by bypassing the obstructed area. The procurement of the saphenous vein graft is considered inclusive in this code and should not be billed separately.Additional procedures, such as harvesting of an upper or lower extremity vein, would require separate coding.
Example 1: A 65-year-old male presents with significant carotid artery stenosis causing transient ischemic attacks (TIAs).A carotid artery bypass graft is deemed necessary, using a vein graft from the leg, to improve blood flow to the brain and prevent stroke., A 72-year-old female with a history of hypertension and hyperlipidemia experiences a stroke caused by complete occlusion of the internal carotid artery. Following a thorough evaluation, a carotid bypass using an autologous vein graft is performed to restore cerebral blood flow., An 80-year-old male with critical carotid artery stenosis is considered a poor candidate for carotid endarterectomy due to multiple comorbidities and significant risk factors.A carotid artery bypass using a synthetic graft (if suitable) is performed to minimize the surgical risk and maintain blood supply to the brain.
** Always refer to the most up-to-date CPT manual, NCCI edits, and payer-specific guidelines for accurate coding and billing.The information provided here is for guidance only and should not be considered exhaustive.Improper coding can lead to claim denials.
- Revenue Code: P2F (Major Procedure, Cardiovascular - Other)
- RVU: This information requires accessing the current Medicare Physician Fee Schedule, which is updated annually.RVUs vary based on geographic location and other factors. Consult the CMS website for precise RVU values and reimbursement details.
- Global Days: The global period for this procedure is not explicitly defined in the provided data and needs to be determined based on current guidelines and payer-specific policies. Typically, global surgical packages include the preoperative, intraoperative, and postoperative periods, which can extend up to 90 days. Check with specific payers for their global days policy.
- Payment Status: Active
- Modifier TC rule: A technical component (TC) modifier would not be applicable to this code, as it refers to the complete surgical procedure.
- Fee Schedule: Historical fee schedule information is unavailable.Consult the CMS website for historical data on Medicare payment rates for this CPT code.
- Specialties:Vascular Surgery, Cardiothoracic Surgery, Neurosurgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center