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2025 CPT code 35884

Revision of a femoral anastomosis of a synthetic arterial bypass graft using an autogenous vein patch graft.

Follow all applicable CPT coding guidelines, including those related to surgical procedures on arteries and veins.Consult the AMA CPT codebook for complete guidelines.

Modifier 50 (Bilateral Procedure) may apply if the procedure is performed bilaterally.Other modifiers may apply depending on the circumstances of the procedure.Consult the most current CPT guidelines and payer specific rules.

Medical necessity is established by the presence of a clinically significant complication at the femoral anastomosis of a synthetic arterial bypass graft, such as stenosis, pseudoaneurysm, infection, or limb ischemia, that requires surgical revision to restore blood flow and/or treat the complication.Supporting documentation should show that conservative measures have been exhausted or are not appropriate.The decision to use an autogenous vein patch should be supported by relevant clinical findings.

The vascular surgeon is responsible for the entire procedure, including patient preparation, incision, harvesting of the autologous vein graft, preparation of the vein patch, anastomosis of the patch to the synthetic graft and native femoral artery, ensuring hemostasis, and wound closure.

IMPORTANT:For a similar procedure using a non-autogenous patch graft, see 35883.Do not report 35884 with 35700, 35875, 35876, or 35883.

In simple words: The doctor repairs a damaged connection between a synthetic blood vessel graft and a leg artery. They use a patch made from the patient's own vein to fix the connection.

This CPT code encompasses the open surgical revision of the femoral anastomosis of a synthetic arterial bypass graft.The procedure involves using an autogenous vein patch graft to repair the connection between the graft and the femoral artery. This includes all steps from incision to closure, encompassing the harvesting and preparation of the autogenous vein patch, application of the patch to the site of the femoral anastomosis, and ensuring adequate blood flow post-procedure.The procedure is typically performed in an operating room under general anesthesia.

Example 1: A patient presents with a pseudoaneurysm at the femoral anastomosis of a previously placed synthetic arterial bypass graft. The surgeon performs a revision of the anastomosis using an autogenous vein patch graft to repair the pseudoaneurysm and restore blood flow., A patient presents with a stenosis at the femoral anastomosis site of a synthetic arterial bypass graft resulting in limb ischemia.The surgeon performs an open surgical revision and reinforces the weakened anastomosis using an autogenous vein patch to improve blood flow to the lower extremity., Following a previous femoral-popliteal bypass grafting procedure, the patient develops an infection at the femoral anastomosis site. The infected tissue is debrided, and the anastomosis is revised with the placement of an autologous vein patch to correct the structural defect and treat the infection.

* Preoperative assessment, including relevant imaging studies (angiograms, ultrasound) to establish diagnosis.* Operative report detailing the surgical steps, type and source of the autogenous vein graft used, and assessment of blood flow post-procedure.* Pathology report, if any tissue was sent for analysis.* Postoperative imaging (angiogram, ultrasound) to confirm patency of the repaired anastomosis.* Follow-up notes documenting the patient's recovery.

** This code should only be used for open surgical procedures.Endovascular approaches would require different codes. Always ensure proper documentation supports the medical necessity and accurate coding of the procedure.

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