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2025 CPT code 35566

Bypass graft, with vein; femoral-anterior tibial, posterior tibial, peroneal artery or other distal vessels.

Procurement of the saphenous vein graft is included. For multiple bypasses, consider modifier 59 if distinct.

Modifiers can be used, such as modifier 59 for distinct procedures.

Medical necessity is established by documenting the impaired blood flow to the lower leg due to a blockage in the femoral artery, and the clinical need for surgical intervention to restore blood flow. Justification may include claudication, rest pain, non-healing ulcers, or gangrene.

The surgeon makes incisions in the groin and lower leg, harvests a vein graft (if needed), and attaches the graft to the femoral and distal arteries, bypassing the blockage.

IMPORTANT:For harvesting of an upper extremity vein, use 35500. For harvesting of a femoropopliteal vein segment, use 35572. For an autogenous composite graft of two segments, use 35682; for three or more segments, use 35683.

In simple words: This surgery creates a detour for blood flow in the leg.A healthy vein is used to create a new pathway around a blocked artery in the thigh, allowing blood to reach the lower leg.

This procedure involves creating a bypass from the femoral artery to a distal artery in the lower leg (anterior tibial, posterior tibial, or peroneal artery) using a vein graft. This is done to bypass a blocked or damaged section of the femoral artery, restoring blood flow to the lower leg.

Example 1: A patient with peripheral artery disease has a blockage in the femoral artery, restricting blood flow to the lower leg. A femoral-anterior tibial bypass using a vein graft is performed., A patient with critical limb ischemia requires a bypass from the femoral artery to the peroneal artery to salvage the limb., Following trauma to the leg, a patient's femoral artery is damaged, necessitating a bypass to the posterior tibial artery.

Documentation should include details of the blockage location, the type of graft used, the arteries involved, and any complications encountered.

** As of December 1, 2024, this information is current but subject to change. Refer to current CPT coding guidelines for the most up-to-date information.

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