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Official Description

Excision of infected graft; abdomen

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 35907 involves the excision of an infected vascular graft located in the abdomen. This surgical intervention is necessary when a vascular graft, which is a synthetic or biological conduit used to restore blood flow, becomes infected. The presence of infection can compromise the function of the graft and the health of the surrounding tissues. In this procedure, the infected graft is carefully removed to prevent further complications. Prior to the excision, a re-vascularization procedure is typically performed, which involves the placement of a new graft to ensure that the affected organ or limb continues to receive adequate blood supply during and after the removal of the infected graft. The surgical team will expose the infected graft and meticulously dissect it from the surrounding tissues. To facilitate the excision, the inflow and outflow arteries are clamped above and below the graft, allowing for a controlled removal. The procedure also includes debridement of the arterial walls at the anastomosis sites to remove any inflamed tissue, ensuring that the repair is made to healthy, non-inflamed arterial tissue. Finally, the arterial defect is repaired with sutures to restore the integrity of the blood vessels.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The excision of an infected graft, as described by CPT® Code 35907, is indicated in the following scenarios:

  • Infected Vascular Graft The primary indication for this procedure is the presence of an infection in a vascular graft located in the abdomen, which can lead to complications if not addressed.
  • Compromised Blood Flow The procedure is also indicated when the infected graft is causing compromised blood flow to the affected organ or limb, necessitating intervention to restore adequate perfusion.

2. Procedure

The procedure for excising an infected vascular graft in the abdomen involves several critical steps:

  • Step 1: Re-vascularization Before the excision of the infected graft, a separately reportable re-vascularization procedure is typically performed. This step is crucial to ensure that the affected organ or limb receives adequate blood supply during the excision process.
  • Step 2: Exposure of the Infected Graft The surgical team will then expose the infected graft by carefully dissecting it free from the surrounding tissues. This step requires precision to avoid damaging adjacent structures.
  • Step 3: Clamping of Arteries Once the graft is exposed, the inflow and outflow arteries are clamped above and below the graft. This clamping is essential to control blood flow and minimize bleeding during the excision.
  • Step 4: Excision of the Graft The infected graft is then excised from the abdominal area. This step involves careful removal to ensure that all infected tissue is taken out.
  • Step 5: Debridement of Arterial Walls After the graft is excised, the inflow and outflow arterial walls at the proximal and distal anastomosis sites are debrided. This debridement continues until healthy, non-inflamed arterial tissue is encountered, ensuring a proper healing environment.
  • Step 6: Debridement of Surrounding Tissue Any inflamed tissue surrounding the graft site is also debrided to further reduce the risk of infection and promote healing.
  • Step 7: Repair of Arterial Defect Finally, the arterial defect created by the excision is repaired using sutures, restoring the integrity of the blood vessels and ensuring proper blood flow post-procedure.

3. Post-Procedure

Post-procedure care following the excision of an infected graft includes monitoring for signs of infection, ensuring proper wound healing, and assessing blood flow to the affected area. Patients may require follow-up imaging studies to evaluate the success of the re-vascularization and the integrity of the arterial repair. Additionally, pain management and possibly antibiotic therapy may be necessary to prevent further infection and promote recovery.

Short Descr EXCISION GRAFT ABDOMEN
Medium Descr EXCISION INFECTED GRAFT ABDOMEN
Long Descr Excision of infected graft; abdomen
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) 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 1
CCS Clinical Classification 61 - Other OR procedures on vessels other than 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).
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).
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)
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
2011-01-01 Changed Short description changed.
1994-01-01 Added First appearance in code book in 1994.
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