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Official Description

Reimplantation, visceral artery to infrarenal aortic prosthesis, each artery (List separately in addition to code for primary procedure)

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 35697 involves the reimplantation of a visceral artery to an infrarenal aortic prosthesis. This surgical intervention is typically performed during a separate open procedure on the aorta, where the physician meticulously dissects the visceral vessel from the surrounding soft tissue to prepare it for reattachment. A critical component of this procedure is the creation of a patch from a button of aortic tissue, which is cut from the origin of the visceral vessel. This patch, often referred to as a Carrel patch, is essential for ensuring a secure and effective reattachment to the aortic prosthesis. The smoothness and patency of the button are carefully examined to confirm its suitability for the procedure. Once the patch is prepared, the site on the aortic prosthesis where the reimplantation will occur is clamped using a side-biting clamp. A corresponding hole is then created in the aortic prosthesis to match the size of the aortic button. The Carrel patch is sutured into this hole, establishing a new connection between the visceral artery and the prosthesis. After the clamps are removed, the anastomosis site is thoroughly checked for any signs of leakage, and additional sutures may be applied as necessary to ensure the integrity of the connection. This procedure is primarily aimed at restoring blood supply to the colon by reimplanting the inferior mesenteric artery into the infrarenal aortic prosthesis, although it can also be performed on other visceral arteries. Each instance of visceral artery reimplantation is reported separately using the code 35697.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 35697 is indicated for the re-establishment of blood supply to the colon, primarily through the reimplantation of the inferior mesenteric artery into the infrarenal aortic prosthesis. This procedure may also be indicated for other visceral arteries that require reattachment to ensure adequate blood flow to the corresponding organs or tissues.

  • Restoration of Blood Supply The primary indication for this procedure is to restore blood supply to the colon by reimplanting the inferior mesenteric artery.
  • Other Visceral Arteries The procedure may also be performed on other visceral arteries that require reattachment to the aortic prosthesis.

2. Procedure

The procedure for reimplantation of a visceral artery to the infrarenal aortic prosthesis involves several critical steps that ensure successful attachment and restoration of blood flow.

  • Step 1: Dissection of the Visceral Vessel The surgeon begins by carefully dissecting the visceral vessel from the surrounding soft tissue. This step is crucial to free the vessel and prepare it for reattachment to the aortic prosthesis.
  • Step 2: Creation of the Aortic Button A button of aortic tissue is then cut from the origin of the visceral vessel. This button will serve as a patch for the reimplantation process and is examined to ensure it is smooth and patent, which is vital for a successful anastomosis.
  • Step 3: Clamping the Aortic Prosthesis The planned reimplantation site on the aortic prosthesis is clamped using a side-biting clamp. This step stabilizes the area and prepares it for the next phase of the procedure.
  • Step 4: Creating the Hole in the Aortic Prosthesis A hole is then cut in the aortic prosthesis that matches the size of the aortic button. This precise matching is essential for ensuring a secure fit during the reattachment.
  • Step 5: Suturing the Carrel Patch The aortic button, or Carrel patch, is sutured to the hole created in the aortic prosthesis. This step establishes the new connection between the visceral artery and the prosthesis.
  • Step 6: Checking for Leakage After the suturing is complete, the clamps are removed, and the anastomosis site is thoroughly checked for any signs of leakage. This ensures that the connection is secure and functioning properly.
  • Step 7: Additional Sutures If necessary, additional sutures are applied at the patch site to reinforce the connection and prevent any potential complications.

3. Post-Procedure

Post-procedure care following the reimplantation of a visceral artery to the infrarenal aortic prosthesis typically involves monitoring the patient for any complications related to the surgery. This includes checking for signs of leakage at the anastomosis site and ensuring that blood flow is adequately restored to the affected areas. Patients may require follow-up imaging studies to assess the success of the reimplantation and to monitor for any potential issues. Additionally, standard post-operative care protocols should be followed to promote healing and recovery.

Short Descr REIMPLANT ARTERY EACH
Medium Descr RIMPLTJ VISC ART INFRARNL AORTIC PROSTH EA ART
Long Descr Reimplantation, visceral artery to infrarenal aortic prosthesis, each artery (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) 2 - Co-surgeons permitted and no documentation required if the two- specialty requirement is met.
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) P1G - Major procedure - Other
MUE 2
CCS Clinical Classification 59 - Other OR procedures on vessels of head and neck
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).
81 Minimum assistant surgeon: minimum surgical assistant services are identified by adding modifier 81 to the usual procedure number.
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
2004-01-01 Added First appearance in code book in 2004.
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