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The CPT® Code 35700 refers to a reoperation procedure involving the femoral-popliteal or femoral (popliteal)-anterior tibial, posterior tibial, peroneal artery, or other distal vessels. This procedure is specifically indicated when a patient requires a second surgical intervention more than one month after the original arterial bypass operation. The need for reoperation often arises due to complications such as stenosis, which is a narrowing of the graft or the inflow and outflow arteries, leading to re-occlusion and potential graft failure. During this procedure, the physician makes an incision over the previously placed bypass graft to access the affected area. The graft, along with the inflow and outflow arteries, is meticulously dissected from the surrounding tissues to ensure proper identification and mobilization of new sites for the bypass. A new inflow site is selected and mobilized proximal to the original anastomosis, while a new outflow site is identified and mobilized distal to the original anastomosis. The reoperation may involve placing a new bypass graft or performing an in-situ bypass, which is a separately reportable procedure. This code is utilized in conjunction with the primary procedure code to accurately reflect the surgical intervention performed.
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The reoperation described by CPT® Code 35700 is indicated in the following scenarios:
The procedural steps for CPT® Code 35700 are as follows:
After the reoperation, the patient will require careful monitoring and post-operative care to ensure proper healing and function of the new graft. Expected recovery may involve managing pain, monitoring for signs of infection, and ensuring that blood flow is restored effectively. Follow-up appointments will be necessary to assess the success of the procedure and to check for any potential complications that may arise following the reoperation.
| Short Descr | REOPERATION BYPASS GRAFT | Medium Descr | ROPRTJ > 1 MO AFTER ORIGINAL OPRATION | Long Descr | Reoperation, femoral-popliteal or femoral (popliteal)-anterior tibial, posterior tibial, peroneal artery, or other distal vessels, more than 1 month after original operation (List separately in addition to code for primary procedure) | Status Code | Active Code | Global Days | ZZZ - Code Related to Another Service | 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) | 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 | 2 | CCS Clinical Classification | 60 - Embolectomy and endarterectomy of lower limbs |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 35556 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Bypass graft, with vein; femoral-popliteal | 35566 | MPFS Status: Active Code APC C CPT Assistant Article Bypass graft, with vein; femoral-anterior tibial, posterior tibial, peroneal artery or other distal vessels | 35570 | MPFS Status: Active Code APC C Illustration for Code Bypass graft, with vein; tibial-tibial, peroneal-tibial, or tibial/peroneal trunk-tibial | 35571 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Bypass graft, with vein; popliteal-tibial, -peroneal artery or other distal vessels | 35583 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code In-situ vein bypass; femoral-popliteal | 35585 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code In-situ vein bypass; femoral-anterior tibial, posterior tibial, or peroneal artery | 35587 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code In-situ vein bypass; popliteal-tibial, peroneal | 35656 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Bypass graft, with other than vein; femoral-popliteal | 35666 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Bypass graft, with other than vein; femoral-anterior tibial, posterior tibial, or peroneal artery | 35671 | MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code Bypass graft, with other than vein; popliteal-tibial or -peroneal artery |
| 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 | 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). | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) 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). | CR | Catastrophe/disaster related | 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) | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | 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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| 2011-01-01 | Changed | Short description changed. |
| 2010-01-01 | Changed | Code description changed. |
| 2007-01-01 | Changed | Code description changed. |
| 1994-01-01 | Added | First appearance in code book in 1994. |
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