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Official Description

Thromboendarterectomy, including patch graft, if performed; abdominal aorta

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Thromboendarterectomy is a surgical procedure aimed at removing a thrombus, which can be a blood clot or atherosclerotic plaque, from the abdominal aorta or other major arteries such as the mesenteric, celiac, or renal arteries. This procedure is essential for restoring blood flow in cases where these arteries have become occluded due to the buildup of plaque or clots that adhere to the vessel walls. The process begins with an incision in the abdomen to access the affected blood vessel. Once exposed, the thrombosed section is carefully isolated and dissected from surrounding tissues. To maintain blood flow during the procedure, a temporary shunt may be placed. Vascular clamps are then applied both proximal and distal to the obstruction, allowing the surgeon to incise the artery and remove the thrombus along with the intima, which is the inner lining of the artery. This removal increases the diameter of the vessel, facilitating better blood flow. After the thrombus and intima are excised, the remaining edges of the normal intima are sutured back to the artery walls. The artery is then repaired, either through primary suturing or by using a patch graft, which can be made from venous or synthetic material to further enlarge the vessel's diameter. Once the repair is complete, any temporary shunts are removed, clamps are released to restore blood flow, and the surgical site is closed in layers to ensure proper healing.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The thromboendarterectomy procedure is indicated for patients experiencing significant arterial occlusion due to thrombus formation or atherosclerotic plaque. The specific conditions that may warrant this procedure include:

  • Abdominal Aortic Occlusion - This condition involves blockage in the abdominal aorta, which can lead to reduced blood flow to the lower extremities and vital organs.
  • Mesenteric Artery Occlusion - This occurs when blood flow to the intestines is compromised, potentially leading to ischemia and abdominal pain.
  • Celiac Artery Occlusion - Blockage in the celiac artery can affect blood supply to the stomach, liver, and spleen, resulting in various gastrointestinal symptoms.
  • Renal Artery Occlusion - This condition can lead to hypertension and renal ischemia, affecting kidney function.

2. Procedure

The thromboendarterectomy procedure involves several critical steps to ensure successful removal of the thrombus and restoration of blood flow. The steps are as follows:

  • Step 1: Access Incision - The procedure begins with a surgical incision in the abdomen to gain access to the abdominal aorta or the affected artery.
  • Step 2: Exposure of the Blood Vessel - Once the incision is made, the surgeon carefully exposes the affected blood vessel, ensuring that surrounding structures are preserved.
  • Step 3: Isolation of the Thrombosed Portion - The thrombosed section of the artery is isolated from adjacent tissues to facilitate safe dissection and removal.
  • Step 4: Placement of Temporary Shunt - To maintain blood flow during the procedure, a temporary shunt may be inserted, allowing perfusion to continue while the obstruction is addressed.
  • Step 5: Application of Vascular Clamps - Clamps are placed both proximal and distal to the obstructed area to control blood flow and create a clear working field.
  • Step 6: Incision of the Artery - The surgeon incises the artery at the site of obstruction, allowing access to the thrombus and plaque.
  • Step 7: Removal of Thrombus and Intima - The thrombus, along with the intima, is carefully excised from the artery to increase its diameter and restore normal blood flow.
  • Step 8: Suturing of the Intima - The edges of the remaining normal intima are sutured back to the artery walls to ensure proper healing and maintain vessel integrity.
  • Step 9: Repair of the Artery - The artery is repaired either primarily with sutures or with a patch graft, which may be venous or synthetic, to enlarge the diameter of the vessel.
  • Step 10: Removal of Temporary Shunt - If a shunt was placed, it is removed after the artery has been repaired.
  • Step 11: Restoration of Blood Flow - The vascular clamps are released, allowing blood flow to resume through the artery.
  • Step 12: Hemostasis Check - The surgical team checks the suture line for any signs of bleeding to ensure hemostasis before closing the incision.
  • Step 13: Closure of the Surgical Site - Finally, the overlying tissues are closed in layers to promote healing and minimize scarring.

3. Post-Procedure

After the thromboendarterectomy procedure, patients are typically monitored for any complications, including bleeding or infection. Recovery may involve a hospital stay where vital signs are closely observed. Patients may be advised on activity restrictions and follow-up appointments to assess the success of the procedure and ensure proper healing. Pain management and wound care instructions will also be provided to facilitate recovery. It is essential for patients to adhere to any prescribed medications, such as anticoagulants, to prevent future thrombus formation and to maintain regular follow-up with their healthcare provider for ongoing assessment of vascular health.

Short Descr RECHANNELING OF ARTERY
Medium Descr TEAEC W/WO PATCH GRAFT ABDOMINAL AORTA
Long Descr Thromboendarterectomy, including patch graft, if performed; abdominal aorta
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) 1 - 150% payment adjustment for bilateral procedures applies.
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
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).
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
CR Catastrophe/disaster related
GC This service has been performed in part by a resident under the direction of a teaching physician
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)
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
2007-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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