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CPT®
0254T

CPT® Code 0254T
Deleted

Code deleted, see 34717, 34718

Official Description

Endovascular repair of iliac artery bifurcation (eg, aneurysm, pseudoaneurysm, arteriovenous malformation, trauma, dissection) using bifurcated endograft from the common iliac artery into both the external and internal iliac artery, including all selective and/or nonselective catheterization(s) required for device placement and all associated radiological supervision and interpretation, unilateral

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 0254T involves the endovascular repair of the iliac artery bifurcation, which may be necessitated by various vascular conditions such as an aneurysm, pseudoaneurysm, arteriovenous malformation, trauma, or dissection. This minimally invasive technique utilizes a bifurcated endograft that is inserted from the common iliac artery into both the external and internal iliac arteries. The procedure is performed under fluoroscopic guidance, which allows for real-time imaging to ensure accurate placement of the graft. The approach typically involves accessing both femoral arteries, with the ipsilateral femoral artery being incised to facilitate the introduction of a guidewire. This guidewire is then navigated to the site of the arterial defect, allowing for the advancement of an introducer sheath that carries the endograft. The contralateral femoral artery is also accessed to ensure proper positioning of the graft within the iliac arteries. The deployment of the endograft is carefully monitored through fluoroscopy to confirm its correct placement and to check for any potential complications, such as endoleaks. This procedure is comprehensive, encompassing all necessary catheterizations and radiological supervision required for successful device placement.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The endovascular repair of the iliac artery bifurcation using CPT® Code 0254T is indicated for the following conditions:

  • Aneurysm - A localized enlargement of the iliac artery that poses a risk of rupture.
  • Pseudoaneurysm - A false aneurysm that occurs when blood leaks out of the artery but is contained by surrounding tissue.
  • Arteriovenous malformation - An abnormal connection between arteries and veins that can lead to complications.
  • Trauma - Injury to the iliac artery that may require surgical intervention to restore normal blood flow.
  • Dissection - A tear in the artery wall that can compromise blood flow and lead to serious complications.

2. Procedure

The procedure for endovascular repair of the iliac artery bifurcation involves several critical steps:

  • Step 1: The procedure begins with the exposure of both femoral arteries, which are accessed to facilitate the introduction of necessary instruments.
  • Step 2: An incision is made in the ipsilateral (same side) femoral artery, allowing for the insertion of a guidewire. This guidewire is carefully advanced to a position just above the defect in the external iliac artery.
  • Step 3: An introducer sheath containing the bifurcated endograft is then advanced over the guidewire and positioned accurately over the external iliac artery defect, utilizing fluoroscopic guidance for precision.
  • Step 4: The contralateral (opposite side) femoral artery is incised, and a guidewire is navigated into the contralateral iliac artery, then into the aorta, and subsequently into the ipsilateral external iliac artery.
  • Step 5: An angled guidewire is employed to access the internal iliac artery, ensuring that the graft can be properly positioned in both the external and internal iliac arteries.
  • Step 6: The correct positioning of the endograft within the external iliac artery is verified through fluoroscopy, after which the guidewire is removed.
  • Step 7: The introducer sheath is then removed, and the external iliac portion of the endograft is deployed into place.
  • Step 8: The limb of the endograft is manipulated into the internal iliac artery, with fluoroscopic verification of its position before deployment.
  • Step 9: A balloon catheter may be utilized as needed to ensure proper seating of the endograft, after which the balloon catheter is removed.
  • Step 10: A pigtail or side-hole catheter is introduced over the guidewire to perform angiography, which evaluates the position of the endograft and checks for any endoleaks.
  • Step 11: Finally, all catheters and guidewires are removed, and the incision in the groin is closed to complete the procedure.

3. Post-Procedure

Post-procedure care following the endovascular repair of the iliac artery bifurcation includes monitoring for any complications such as bleeding or infection at the incision site. Patients may be advised to limit physical activity for a specified period to promote healing. Follow-up imaging may be required to ensure the proper positioning of the endograft and to check for any potential endoleaks. The healthcare provider will provide specific instructions regarding recovery and any necessary follow-up appointments.
Short Descr EVASC RPR ILIAC ART BIFUR
Medium Descr EVASC RPR ILAC ART BIFUR ENDGRFT CATHJ RS&I UNI
Long Descr Endovascular repair of iliac artery bifurcation (eg, aneurysm, pseudoaneurysm, arteriovenous malformation, trauma, dissection) using bifurcated endograft from the common iliac artery into both the external and internal iliac artery, including all selective and/or nonselective catheterization(s) required for device placement and all associated radiological supervision and interpretation, unilateral
Status Code Carriers Price the Code
Global Days YYY - Carrier Determines Whether Global Concept Applies
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Inpatient Procedures, not paid under OPPS
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P2E - Major procedure, cardiovascular-Pacemaker insertion
MUE Not applicable/unspecified.
CCS Clinical Classification 61 - Other OR procedures on vessels other than head and neck
Date
Action
Notes
2019-12-31 Deleted Code deleted, see 34717, 34718
2018-01-01 Changed First appearance of change in code book.
2018-01-01 Changed Long medium and short descriptions changed.
2017-07-01 Changed Short, medium and long descriptions revised.
2017-01-01 Changed Code description changed.
2011-01-01 Added Added
Code
Description
Code
Description
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