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Official Description

Placement of femoral-femoral prosthetic graft during endovascular aortic aneurysm repair (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 34813 involves the placement of a femoral-femoral prosthetic graft during an endovascular aortic aneurysm repair. This surgical intervention is specifically indicated when one iliac artery remains patent, while the other is affected by occlusive disease. The femoral-femoral graft serves as a bypass to restore blood flow from the healthy femoral artery to the occluded femoral artery, thereby facilitating adequate circulation. The procedure utilizes a tunneling device to create a subcutaneous tunnel that arches across the abdomen, connecting the two femoral arteries. This approach is essential for patients who require an endovascular repair of an abdominal aortic aneurysm, as it allows for the effective management of vascular occlusions while minimizing the need for more invasive surgical techniques. The careful selection of an appropriately sized conduit and the meticulous anastomosis of the graft to the femoral arteries are critical steps in ensuring the success of the procedure and the restoration of normal blood flow.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The placement of a femoral-femoral prosthetic graft is indicated in specific clinical scenarios where there is a need to bypass an occluded femoral artery during an endovascular aortic aneurysm repair. The following conditions warrant this procedure:

  • Patent Iliac Artery The presence of one iliac artery that is patent, allowing for adequate blood flow.
  • Occlusive Disease The presence of occlusive disease in the contralateral iliac artery, necessitating the need for a bypass to restore circulation.

2. Procedure

The procedure for placing a femoral-femoral prosthetic graft involves several critical steps that ensure successful graft placement and restoration of blood flow. The following procedural steps are performed:

  • Step 1: Tunneling Device Utilization A tunneling device is employed to create an arched subcutaneous tunnel that extends from the patent femoral artery across the abdomen to the occluded femoral artery. This step is crucial for establishing a pathway for the graft.
  • Step 2: Conduit Selection An appropriately sized conduit is selected based on the anatomical requirements of the patient. This conduit will serve as the graft that connects the two femoral arteries.
  • Step 3: Heparin Administration Prior to clamping the femoral arteries, heparin is administered to prevent clot formation during the procedure.
  • Step 4: Bilateral Clamping The femoral arteries are clamped bilaterally to control blood flow and facilitate the anastomosis of the graft.
  • Step 5: Incision and Anastomosis The common femoral artery is incised on one side, and the conduit is anastomosed to this artery. Following this, the common femoral artery on the opposite side is also incised, and the graft is anastomosed to it as well.
  • Step 6: Blood Flow Verification After the anastomosis is complete, the vascular clamps are removed, and blood flow through the graft is checked using a handheld Doppler device to ensure that the graft is functioning properly.

3. Post-Procedure

Post-procedure care involves monitoring the patient for any signs of complications, such as graft occlusion or infection. Patients are typically observed for adequate blood flow and may undergo imaging studies to assess the patency of the graft. Recovery may vary based on individual patient factors, but close follow-up is essential to ensure the success of the graft and the overall outcome of the endovascular aortic aneurysm repair.

Short Descr FEMORAL ENDOVAS GRAFT ADD-ON
Medium Descr PLMT FEM-FEM PROSTC GRF EVASC AORTIC ARYSM RPR
Long Descr Placement of femoral-femoral prosthetic graft during endovascular aortic aneurysm repair (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) P2F - Major procedure, cardiovascular-Other
MUE 1
CCS Clinical Classification 61 - Other OR procedures on vessels other than head and neck

This is an add-on code that must be used in conjunction with one of these primary codes.

34812 Addon Code Resequenced Code MPFS Status: Active Code APC C CPT Assistant Article Open femoral artery exposure for delivery of endovascular prosthesis, by groin incision, unilateral (List separately in addition to code for primary procedure)
34808 Addon Code MPFS Status: Active Code APC C CPT Assistant Article Endovascular placement of iliac artery occlusion device (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.
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)
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
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
Date
Action
Notes
2001-01-01 Added First appearance in code book in 2001.
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