Coding Ahead
CasePilot
Medical Coding Assistant
Case2Code
Search and Code Lookup Tool
RedactPHI
HIPAA-Compliant PHI Redaction
DetectICD10CM
ICD-10-CM Code Detection
Log in Register free account
1 code page views remaining. Guest accounts are limited to 1 page view. Register free account to get 5 more views.
Log in Register free account

Official Description

Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm and associated occlusive disease, carotid, subclavian artery, by neck incision

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 35001 refers to the surgical procedure for the direct repair of an aneurysm or pseudoaneurysm, as well as the excision (either partial or total) and graft insertion, which may include the use of a patch graft. This procedure specifically targets the carotid or subclavian artery and is performed through a neck incision. An aneurysm is characterized by an abnormal enlargement or dilation of an artery, which can arise from various causes such as arteriosclerosis, mechanical obstructions like thoracic outlet syndrome, or malposition of the artery. Less frequently, aneurysms may be caused by infections such as syphilis or tuberculosis, or by structural abnormalities of the vessel wall, such as fibromuscular dysplasia. In contrast, a pseudoaneurysm is a condition that does not involve all three layers of the artery wall and is often the result of trauma—either blunt or penetrating—or complications from medical procedures, such as catheterization. This results in a pulsating hematoma that is encapsulated and communicates directly with the artery wall. The surgical approach for this procedure may involve harvesting a saphenous vein graft from the lower leg if necessary. The operation begins with an incision in the neck, and in cases involving the subclavian artery, a portion of the clavicle may be excised to enhance access. Careful dissection of the overlying soft tissues is performed while protecting critical structures such as the phrenic nerve. The underlying artery is then exposed, and necessary clamping is done to control blood flow. The aneurysm sac is opened, and any thrombus or plaque is removed before the artery walls are repaired and a graft is applied as needed. This procedure is classified as nonemergent and elective, distinguishing it from similar procedures that may be performed in emergency situations, such as the repair of a ruptured aneurysm.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 35001 is indicated for the surgical repair of aneurysms or pseudoaneurysms of the carotid or subclavian artery, particularly when associated with occlusive disease. The following conditions may warrant this procedure:

  • Aneurysm An abnormal enlargement or dilation of the carotid or subclavian artery that requires surgical intervention.
  • Pseudoaneurysm A hematoma that forms in communication with the artery wall, often resulting from trauma or procedural complications.
  • Associated Occlusive Disease Conditions that may compromise blood flow in conjunction with the presence of an aneurysm.

2. Procedure

The procedure for CPT® Code 35001 involves several critical steps to ensure the successful repair of the aneurysm or pseudoaneurysm:

  • Step 1: Preparation and Anesthesia The patient is positioned appropriately, and the surgical site is prepped and draped. Anesthesia is administered to ensure the patient is comfortable and pain-free during the procedure.
  • Step 2: Incision A neck incision is made to access the carotid or subclavian artery. In cases where the subclavian artery is involved, a portion of the clavicle may be excised to facilitate better access to the artery.
  • Step 3: Dissection The overlying soft tissues, including the platysma and/or scalene muscles, are carefully divided. During this step, the phrenic nerve must be protected to avoid complications.
  • Step 4: Exposure of the Artery The underlying common carotid, internal carotid, external carotid, or subclavian artery is exposed. Clamps are applied to the subclavian, common carotid, and innominate arteries as necessary to control blood flow.
  • Step 5: Aneurysm Sac Management The aneurysm sac is opened, and any thrombus or plaque is meticulously removed to prepare the artery for repair.
  • Step 6: Repair Techniques The artery walls are sutured together, and an autogenous (saphenous vein) or synthetic patch graft is applied as needed. Alternatively, the aneurysm may be excised, and an end-to-end anastomosis of the distal and proximal vessel ends may be performed, with or without a patch graft. Another option is to insert an autogenous (saphenous vein) or synthetic tube graft, which involves making a longitudinal incision in the artery, inserting the graft, and suturing it to the healthy artery on either side of the aneurysm.
  • Step 7: Closure After the graft is secured, the aneurysm sac is closed over the graft. The clamps are then released, and blood flow is re-established through the repaired artery.

3. Post-Procedure

Post-procedure care for patients undergoing the repair of an aneurysm or pseudoaneurysm includes monitoring for any signs of complications, such as bleeding or infection at the incision site. Patients may require pain management and will be observed for any changes in neurological status, particularly if the carotid artery was involved. Follow-up appointments are essential to assess the success of the repair and to monitor for any potential recurrence of the aneurysm or related complications. Patients may also be advised on lifestyle modifications and medication management to reduce the risk of future vascular issues.

Short Descr REPAIR DEFECT OF ARTERY
Medium Descr DIR RPR ANEURYSM CAROTID-SUBCLAVIAN ARTERY
Long Descr Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm and associated occlusive disease, carotid, subclavian artery, by neck incision
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 1 - 150% payment adjustment for bilateral procedures applies.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 2 - Payment restriction for assistants at surgery does not apply to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
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) P2F - Major procedure, cardiovascular-Other
MUE 1
CCS Clinical Classification 59 - Other OR procedures on vessels of head and neck

This is a primary code that can be used with these additional add-on codes.

35572 Addon Code MPFS Status: Active Code APC N ASC N1 CPT Assistant Article Illustration for Code Harvest of femoropopliteal vein, 1 segment, for vascular reconstruction procedure (eg, aortic, vena caval, coronary, peripheral artery) (List separately in addition to code for primary procedure)
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
62 Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
GC This service has been performed in part by a resident under the direction of a teaching physician
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
Date
Action
Notes
2013-01-01 Changed Medium Descriptor changed.
2002-01-01 Changed Code description changed.
Pre-1990 Added Code added.
Code
Description
Code
Description
Code
Description
Code
Description
Code
Description
CasePilot

Get instant expert-level medical coding assistance.

Ask about:
CPT Codes Guidelines Modifiers Crosswalks NCCI Edits Compliance Medicare Coverage
Example: "What is CPT code 99213?" or "Guidelines for E/M services"