2025 CPT code 35556
(Active) Effective Date: N/A Revision Date: N/A Surgery - Vascular Procedures Surgery Feed
Femoropopliteal bypass graft using a vein.
Modifiers may be applicable depending on the circumstances of the procedure.Consult current CPT guidelines and payer-specific instructions for specific modifier usage (e.g., 51 for multiple procedures, 59 for distinct procedural service, 22 for increased procedural services).
Medical necessity is established when conservative management fails to improve symptoms, or when critical limb ischemia or limb-threatening ischemia is present.Documentation must support the severity of the patient's symptoms, the lack of response to conservative therapy, and the need for surgical intervention to restore perfusion to the limb.
The surgeon's responsibilities include preparing the patient, making incisions to access the femoral and popliteal arteries, harvesting a vein graft (if necessary), creating an anastomosis between the graft and the arteries, restoring blood flow, and closing the incisions.
In simple words: The doctor creates a new pathway for blood to flow around a blocked artery in your leg, using a vein graft from elsewhere in your body. This bypass helps restore blood flow to your lower leg and foot.
This CPT code, 35556, signifies a surgical procedure where a bypass graft, constructed from a vein, is used to redirect blood flow around an obstructed section of the femoral-popliteal artery.The procedure involves creating an anastomosis between the graft and both the femoral and popliteal arteries, restoring blood flow to the lower limb. The specific vein used for the graft is not explicitly specified in the code.
Example 1: A patient presents with critical limb ischemia due to a significant blockage in the femoropopliteal artery.The patient is experiencing severe pain at rest and has non-healing ulcers. Femoropopliteal bypass with a vein graft is performed to restore blood flow and save the limb., A patient with peripheral arterial disease (PAD) exhibits intermittent claudication, limiting their ability to walk. Angioplasty is unsuccessful. A femoropopliteal bypass using a harvested great saphenous vein is chosen to improve blood flow and alleviate claudication., A patient with a history of diabetes and PAD has a long segment of occlusion in the popliteal artery.The surgeon performs a femoropopliteal bypass, using an autologous vein graft.The use of a synthetic graft is contraindicated due to the patient's diabetic condition.
Preoperative assessment, including history and physical examination, noninvasive vascular studies (ABI, Doppler ultrasound, angiography), operative report detailing the type of graft used (autologous vein, synthetic), location of anastomoses, and intraoperative findings. Postoperative angiography and follow-up clinical assessments are also required.
** The type of vein used for the graft is not specified in the code.Detailed documentation is crucial to ensure accurate coding and reimbursement.Always refer to the most current CPT and payer guidelines for accurate coding and billing practices.
- Revenue Code: P2F (MAJOR PROCEDURE, CARDIOVASCULAR - OTHER)
- RVU: This information is not provided in the source data. Refer to the most up-to-date Medicare Physician Fee Schedule for RVU values and reimbursement rates.
- Global Days: The global period for this procedure is not specified in the provided data.Consult current CPT guidelines or payer-specific information for details.
- Payment Status: Active
- Modifier TC rule: The provided data does not specify a Technical Component (TC) modifier rule. Refer to current CPT guidelines and payer-specific instructions for determining if TC modifiers apply in specific scenarios.
- Fee Schedule: Historical fee schedule data is not provided in the source data.Consult historical Medicare Physician Fee Schedules or other relevant sources for such information.
- Specialties:Vascular Surgery, General Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center