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The procedure described by CPT® Code 35266 involves the surgical repair of a blood vessel located in the upper extremity using a graft that is not derived from a vein. This type of intervention is typically necessary when there is significant damage to an artery or other blood vessel in the arm, which may occur due to trauma, disease, or other medical conditions. The surgical approach is tailored to the specific vessel that has sustained injury, ensuring that the repair is both effective and minimizes further complications. During the procedure, the injured blood vessel is carefully exposed, and clamps are applied both proximal and distal to the site of injury to control any bleeding that may occur. In some cases, a temporary shunt may be placed to maintain blood flow while the surgical repair is being performed. The surgeon evaluates the extent of the injury to determine the most appropriate type of graft to use, which may involve harvesting a segment of artery or utilizing a synthetic graft material. The damaged edges of the blood vessel are meticulously debrided to promote healing, and the graft is then securely sutured to the ends of the injured vessel. After the graft is in place, the temporary shunt is removed, clamps are released, and hemostasis is thoroughly checked to ensure there is no bleeding at the suture line. Finally, the surrounding tissues are repaired in layers to restore the integrity of the arm's anatomy.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure associated with CPT® Code 35266 is indicated for the repair of a blood vessel in the upper extremity when there is significant injury or damage that necessitates surgical intervention. The following conditions may warrant this procedure:
The surgical procedure for CPT® Code 35266 involves several critical steps to ensure the successful repair of the injured blood vessel. The following outlines the procedural steps:
After the completion of the procedure associated with CPT® Code 35266, the patient will typically be monitored for any signs of complications, such as bleeding or infection. Post-operative care may include pain management, wound care instructions, and guidelines for activity restrictions to promote healing. The patient may also require follow-up appointments to assess the success of the graft and ensure proper blood flow is restored to the upper extremity. Rehabilitation may be recommended to regain strength and function in the affected arm.
| Short Descr | RPR BLVSL GRF OTH/TH VN UXTR | Medium Descr | RPR BLOOD VSL GRF OTH/THN VEIN UPPER EXTREMITY | Long Descr | Repair blood vessel with graft other than vein; upper extremity | 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 | Hospital Part B services paid through a comprehensive APC | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P2F - Major procedure, cardiovascular-Other | MUE | 2 | CCS Clinical Classification | 61 - Other OR procedures on vessels other than head and neck |
| F9 | Right hand, fifth digit | 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). | 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. | 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). | 99 | Multiple modifiers: under certain circumstances 2 or more modifiers may be necessary to completely delineate a service. in such situations modifier 99 should be added to the basic procedure, and other applicable modifiers may be listed as part of the description of the service. | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | F1 | Left hand, second digit | GC | This service has been performed in part by a resident under the direction of a teaching physician | GW | Service not related to the hospice patient's terminal condition | 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) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2025-01-01 | Changed | Short Description changed. |
| Pre-1990 | Added | Code added. |
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