2025 CPT code 34845
(Active) Effective Date: N/A Revision Date: N/A Surgery - Endovascular Procedures Cardiovascular System Feed
Endovascular repair of the visceral and infrarenal abdominal aorta using a fenestrated visceral aortic endograft and a concomitant unibody or modular infrarenal aortic endograft, including one visceral artery endoprosthesis.
Modifiers may apply based on the specific circumstances of the procedure.Consult your local Medicare fee schedule or payer guidelines for modifier application rules.
Medical necessity is established based on the presence of a life-threatening condition, such as an abdominal aortic aneurysm or other visceral aortic pathology, that poses a significant risk of rupture and mortality.The procedure is considered medically necessary when less invasive alternatives are insufficient or not feasible.
The clinical responsibility includes pre-operative planning, imaging interpretation, vascular access, endograft deployment, visceral artery endoprosthesis placement, post-procedural angiography, and follow-up care.
In simple words: This code describes a minimally invasive procedure to fix a weakened or damaged area in the large blood vessel (aorta) in the abdomen. A special mesh tube with small openings is placed inside the aorta to support the weakened area. Another smaller tube is placed into one of the branches of the aorta to help restore normal blood flow. Imaging guidance is used throughout the procedure.
This CPT code, 34845, encompasses the endovascular repair of both the visceral and infrarenal portions of the abdominal aorta.The procedure involves the placement of a fenestrated visceral aortic endograft, designed with openings to accommodate visceral artery branches, along with a concomitant unibody or modular infrarenal aortic endograft.The associated radiological supervision and interpretation, including any necessary target zone angioplasty, are included.This specific code indicates the deployment of one visceral artery endoprosthesis (superior mesenteric, celiac, or renal artery).The repair addresses conditions such as aneurysms, pseudoaneurysms, dissections, penetrating ulcers, intramural hematomas, or traumatic disruptions.
Example 1: A 70-year-old male presents with a large infrarenal abdominal aortic aneurysm and significant involvement of the visceral aorta.A fenestrated endograft is used to repair the aneurysm and maintain perfusion to the visceral arteries. One visceral artery endoprosthesis is placed., A 65-year-old female with a history of aortic dissection presents with a visceral aortic aneurysm requiring repair.A fenestrated endograft is used with concomitant unibody infrarenal endograft placement and deployment of one visceral artery endoprosthesis., A 75-year-old male is diagnosed with a traumatic disruption of the visceral and infrarenal aorta.Emergency endovascular repair using a fenestrated endograft is performed, along with a modular infrarenal endograft and placement of one visceral artery endoprosthesis.
Comprehensive documentation should include pre-operative imaging (CT, CTA, MRI), procedural notes detailing the technique, device specifications, post-operative angiography results, and any complications.Medical necessity documentation should support the need for the procedure based on the patient's condition.
** This information is for general guidance only and should not be considered exhaustive.Always consult the latest CPT manual and payer-specific guidelines for definitive coding and reimbursement information.
- RVU: The RVUs for this code vary based on geographic location and payer.Consult your local Medicare fee schedule or payer-specific guidelines for current values.
- Global Days: The global period for this procedure is determined by payer-specific guidelines and may vary.
- Payment Status: Active
- Modifier TC rule: A technical component (TC) modifier is not typically applicable to this code, as it represents a complete procedure.
- Fee Schedule: The historical fee schedule for this code is not readily available; consult the AMA's CPT codes database for more information.
- Specialties:Vascular Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center