2025 CPT code 35665
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Surgery Feed
Creation of an iliofemoral bypass graft using a synthetic graft to bypass an iliac artery blockage.
Modifiers may apply depending on the specific circumstances of the procedure (e.g., 50 for bilateral procedures, 51 for multiple procedures, 59 for distinct procedural services).
Medical necessity for an iliofemoral bypass is established by the presence of significant iliac artery disease causing symptoms such as claudication, rest pain, or critical limb ischemia.The procedure is indicated when conservative management fails or when limb salvage is necessary.
The surgeon is responsible for all aspects of the procedure, from pre-operative preparation and incision to post-operative assessment of graft patency.
In simple words: The doctor uses a synthetic tube (graft) to reroute blood flow around a blockage in an artery in the groin area. This is done by making small cuts near the blocked artery and attaching the tube to bypass the blockage.The doctor will then close the incisions.
This procedure involves creating a bypass around a blockage in the iliac artery using a synthetic graft.The surgeon makes incisions over the iliac artery (in the abdomen) and the femoral artery (in the upper thigh). Clamps are applied to the iliac artery, and the diseased portion is ligated or incised. One end of the synthetic graft is then attached to the iliac artery. The graft is tunneled to the femoral artery, where the other end is attached (end-to-side or side-to-side). Clamps are released, and the graft is checked for leaks.Post-operative arteriography or ultrasound may be used to assess graft patency. The incisions are closed in layers, and a drain may be placed.
Example 1: A 65-year-old male presents with severe claudication (leg pain) due to a significant stenosis (narrowing) in his right iliac artery.An iliofemoral bypass is performed to restore blood flow to his leg. , A 70-year-old female with a history of peripheral artery disease (PAD) experiences critical limb ischemia (CLI) in her left leg.An iliofemoral bypass is performed to revascularize the limb and prevent amputation., A 58-year-old male is diagnosed with an iliac artery occlusion causing significant pain and tissue damage in the leg. The surgeon performs an iliofemoral bypass with a synthetic graft. The patient later undergoes an arteriography to assess patency.
Pre-operative assessment including patient history, physical exam, and imaging (angiography, ultrasound). Intra-operative documentation including type of graft, location of incisions and anastomosis, details of surgical technique. Post-operative documentation including patency of the graft (arteriography or ultrasound), complications, and recovery progress.
** The choice of graft material (e.g., Dacron, PTFE) should be documented.This code describes a unilateral procedure; for bilateral procedures, appropriate coding is required.Always check for any updates or changes to coding guidelines from the AMA or other relevant authorities.
- Revenue Code: P2F (MAJOR PROCEDURE, CARDIOVASCULAR - OTHER)
- Payment Status: Active
- Specialties:Vascular Surgery, Cardiothoracic Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center