2025 CPT code 35190
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on Arteries and Veins Surgery Feed
Repair of acquired or traumatic arteriovenous fistula in extremities.
Modifiers may be applicable depending on the circumstances of the procedure.Refer to the CPT codebook and your payer's guidelines for appropriate modifier use.Examples include 51 (multiple procedures), 59 (distinct procedural service), and others as clinically indicated.
Medical necessity for this procedure is established when an acquired or traumatic AVF is causing clinically significant symptoms, such as pain, swelling, or compromised circulation. Documentation must support the need for repair.
The vascular surgeon is responsible for the pre-operative assessment, surgical procedure, and post-operative care of the patient.
In simple words: This code describes a surgical procedure to fix an abnormal connection between an artery and a vein in an arm or leg.The surgeon will make a cut, repair the abnormal connection, and close the wound.
This CPT code encompasses the surgical repair of an arteriovenous fistula (AVF) that is acquired or traumatic in origin, located in the extremities. The procedure involves making an incision to access the AVF, carefully dissecting the surrounding tissues and vessels, clamping the artery and vein on either side of the fistula, severing the abnormal connection, and then repairing both the artery and vein.Post-operative assessment of blood flow (e.g., using Doppler ultrasound) is included.The surgical incision is then closed in layers.The code includes all necessary steps to establish inflow and outflow.
Example 1: A patient presents with a traumatic AVF in their forearm following a motor vehicle accident.The surgeon performs an open repair of the AVF using 35190., A patient with a history of intravenous drug abuse develops an AVF in their upper arm.The surgeon repairs the fistula using 35190., A patient presents with a spontaneously occurring AVF in their lower leg that is causing significant discomfort and compromising circulation. The surgeon repairs the AVF.
* Preoperative assessment including clinical history, physical examination, and imaging studies (e.g., ultrasound, angiography) documenting the presence and location of the AVF.* Operative report detailing the surgical approach, repair technique, and closure.* Postoperative assessment including assessment of blood flow and wound healing.* Any complications encountered during the procedure or postoperatively.
** Always consult the latest CPT codebook and your payer's guidelines for the most up-to-date information on coding, reimbursement, and medical necessity.
- Revenue Code: P2F (Major Procedure, Cardiovascular - Other)
- RVU: The RVUs for this code will vary depending on the geographic location and other factors.Consult your local Medicare Administrative Contractor (MAC) for specific RVU values.
- Global Days: The global period for this procedure will vary based on payer and local standards.Refer to your payer's specific guidelines.
- Payment Status: Active
- Modifier TC rule: A technical component (TC) modifier would not typically be used with this code because it represents the entire surgical procedure.
- Fee Schedule: Historical fee schedules are not readily available in a standardized format. Check your local payer's historical reimbursement data for more information.
- Specialties:Vascular Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center