CPT® Code 35121

Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, hepatic, celiac, renal, or mesenteric artery

The CPT® Code 35121 refers to the surgical procedure involving the direct repair of an aneurysm or pseudoaneurysm, as well as the excision (either partial or total) and graft insertion, which may include the use of a patch graft. This procedure specifically targets aneurysms, pseudoaneurysms, and any associated occlusive disease affecting the hepatic, celiac, renal, or mesenteric arteries. An aneurysm is characterized by an abnormal enlargement or dilation of an artery, which can arise from various causes such as arteriosclerosis, mechanical obstruction, or malposition of the artery. Less frequently, conditions like syphilis, tuberculosis, or abnormalities in the vessel wall, such as fibromuscular dysplasia, may also lead to aneurysm formation. In contrast, a pseudoaneurysm is defined as a hematoma that forms in direct communication with the artery wall but does not involve all three layers of the arterial wall, distinguishing it from a true aneurysm. Pseudoaneurysms often result from trauma—either blunt or penetrating—or complications from medical procedures, such as catheterization. Specific conditions, such as pancreatitis, septic emboli, or arteritis, can also contribute to the development of a pseudoaneurysm, particularly in the splenic artery. The celiac artery, which supplies blood to the liver, stomach, and spleen, branches off the abdominal aorta just below the diaphragm. The hepatic artery is a branch of the celiac trunk, while the renal arteries and the superior and inferior mesenteric arteries are additional visceral branches of the aorta. The surgical procedure described by CPT® Code 35121 is performed in a nonemergent, elective setting, contrasting with CPT® Code 35122, which pertains to the emergency repair of a ruptured aneurysm. The detailed surgical steps involved in this procedure include accessing the affected artery, establishing control over blood flow, and performing the necessary repairs or graft insertions to restore normal arterial function.