2025 CPT code 35121
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Surgery Feed
Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, hepatic, celiac, renal, or mesenteric artery.
Modifiers may be applied depending on the circumstances, such as modifier 51 (multiple procedures) if additional procedures are performed during the same session, or modifier 22 (increased procedural services) if the procedure was significantly more complex than usual.
Medical necessity for this procedure is established by the presence of a symptomatic or life-threatening aneurysm or pseudoaneurysm of the hepatic, celiac, renal, or mesenteric arteries.The condition poses a high risk of rupture and potentially fatal hemorrhage.The documented clinical presentation, including symptoms and imaging findings, must support the need for surgical intervention.The type and extent of the repair are determined based on the clinical evaluation and intraoperative findings.
The clinical responsibility lies with a vascular surgeon or a general surgeon with expertise in vascular surgery.The surgeon's responsibilities encompass the entire procedure, from pre-operative assessment and planning to the intra-operative repair and post-operative care.This includes meticulous dissection of the affected artery, precise repair techniques, and assessment of blood flow restoration.
In simple words: This code covers surgery to fix a weakened or damaged area in a major artery in your abdomen (like the arteries that supply the liver, stomach, kidneys, or intestines). The doctor will make an incision, repair the damaged area, and may add a graft to help restore normal blood flow.
This CPT code encompasses the surgical repair of an aneurysm or pseudoaneurysm, or partial/total excision, in the hepatic, celiac, renal, or mesenteric arteries.The procedure involves direct repair of the affected vessel, which may include the insertion of a graft (either a vascular graft or a patch graft) to restore blood flow.Associated occlusive disease is also addressed during this procedure. The surgeon will make an abdominal incision to access the affected artery, carefully dissect the surrounding tissues, clamp the proximal and distal ends of the aneurysm or pseudoaneurysm, excise the damaged section, and then either directly suture the remaining ends of the artery or insert the graft material to restore the vessel's integrity and patency.
Example 1: A 65-year-old male patient presents with a ruptured hepatic artery aneurysm.The surgeon performs an open surgical repair with resection of the aneurysmal segment and insertion of a Dacron graft. Code 35121 is used to report this procedure., A 70-year-old female patient has a large pseudoaneurysm of the celiac artery following a previous abdominal aortic aneurysm repair. The surgeon performs an open surgical repair, excising the pseudoaneurysm and suturing the artery. Code 35121 is appropriate., A 50-year-old male patient sustains a traumatic renal artery injury, resulting in a pseudoaneurysm. The surgeon performs an open repair, including ligation of the pseudoaneurysm and reconstruction of the artery using a synthetic graft. Code 35121 is used.
Pre-operative imaging (angiography, CT scan, ultrasound), operative report detailing the surgical approach, repair technique, graft type and size (if applicable), intraoperative findings, postoperative imaging (angiography, CT scan) to confirm the repair and patency, and pathology report if tissue was excised.
** This code is used for open surgical repair only.Endovascular approaches are coded differently.
- Revenue Code: P2F (MAJOR PROCEDURE, CARDIOVASCULAR - OTHER)
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Vascular Surgery, General Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center