2025 CPT code 35683
(Active) Effective Date: N/A Revision Date: N/A Surgery - Composite Graft Procedures on Arteries and Veins Surgical Procedures on Arteries and Veins Feed
Add-on code for harvesting and anastomosing three or more vein segments from two or more distant sites to create a composite bypass graft.
Modifiers may be applicable depending on the circumstances of the procedure.Consult the CPT manual for appropriate modifier usage.
The medical necessity for this procedure is established by the presence of significant peripheral artery disease resulting in critical limb ischemia or other life-threatening conditions requiring arterial revascularization.The need for a composite graft is usually due to the insufficient length of autogenous vein available in a single harvest site.The decision to use a composite graft should be clinically justified based on the patient’s anatomy and the surgeon's judgment.
The surgeon is responsible for harvesting the vein segments from different sites, preparing the segments, creating the composite graft by anastomosing the segments, and incorporating the graft into the bypass procedure.Anesthesia may be provided by the surgeon or an anesthesiologist.
- Surgical Procedures on Arteries and Veins
- 35681-35683 (Composite Graft Procedures on Arteries and Veins)
In simple words: This code describes a surgical procedure where the doctor takes several pieces of vein from different parts of the body (usually a leg or arm) to create a longer, stronger vein. This new, longer vein is then used to create a detour around a blocked artery, improving blood flow.
This add-on code, 35683, reports the harvesting and anastomosis of three or more vein segments from two or more distant sites to construct a composite autogenous vein graft for use as an arterial bypass conduit.The vein segments are harvested from a limb other than the one where the bypass is performed. This code is reported in addition to the primary code for the bypass graft placement. It includes the harvesting, preparation, and anastomosis of the multiple vein segments.
Example 1: A patient presents with critical lower extremity ischemia due to severe atherosclerotic disease.The surgeon determines that a long bypass graft is necessary to restore blood flow and performs a femoro-popliteal bypass using a composite graft created using three vein segments harvested from the patient's leg and arm. Code 35683 is reported in addition to the primary bypass graft code., A patient requires aortofemoral bypass due to extensive aortoiliac disease.Sufficient length of autogenous vein is unavailable in a single location. The surgeon harvests multiple segments from both legs, constructing a composite graft. Code 35683 is added to the primary bypass procedure code., In a patient with significant infrainguinal arterial disease, a composite graft is needed.The surgeon harvests two segments from one leg and one from the other, creating a three-segment graft used for a femoro-distal bypass.Code 35683 is reported with the appropriate bypass code.
* Operative report detailing the harvesting sites, lengths, and preparation of each vein segment.* Detailed description of the anastomosis technique used to create the composite graft.* Documentation of the patency testing of the composite graft prior to implantation.* Preoperative and postoperative angiography to demonstrate the need for the bypass and the patency of the bypass graft.* Complete anesthesia record if applicable.
** The number of vein segments harvested and the specific locations of harvesting may influence the overall time and complexity of the procedure.Accurate documentation is critical for appropriate reimbursement.
- Revenue Code: P6C (MINOR PROCEDURES - OTHER)
- RVU: Information not available in provided text.RVUs vary by location and payer.
- Global Days: Information not provided. Global surgical days vary depending on the primary procedure code used in conjunction with 35683. Consult the appropriate global package definition for the linked procedure code.
- Payment Status: Active
- Modifier TC rule: Information not available in the provided source. The application of a TC modifier depends on the specifics of the procedure and local billing practices.
- Fee Schedule: Information not available in provided text.Fee schedules vary by payer and location.
- Specialties:Vascular Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center