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Official Description

Transluminal balloon angioplasty, percutaneous; brachiocephalic trunk or branches, each vessel

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 35475 refers to transluminal balloon angioplasty performed percutaneously on the brachiocephalic trunk or its branches, with each vessel treated being billed separately. This minimally invasive technique is utilized to open narrowed or blocked arteries, specifically targeting the brachiocephalic artery, which is a major vessel supplying blood to the right arm and head. The process begins with the preparation of the skin over the access artery, typically the brachiocephalic artery, followed by puncturing the artery with a needle to insert a sheath. A guidewire is then navigated through the access point into the occluded area of the artery. A catheter equipped with a balloon tip is advanced over this guidewire to the site of the blockage. Once positioned, the balloon is inflated, compressing the plaque against the arterial wall to restore blood flow. This inflation may be repeated multiple times to achieve optimal results. After the angioplasty, the catheter is exchanged for a guidewire, and an angiography catheter is introduced to assess the success of the procedure through completion angiography, ensuring the artery is patent. Finally, the angiography catheter is removed, and pressure is applied to the puncture site to prevent bleeding, followed by the application of a pressure dressing. This comprehensive approach allows for effective treatment of arterial blockages in the brachiocephalic trunk or branches.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure is indicated for patients presenting with conditions that result in stenosis or occlusion of the brachiocephalic trunk or its branches. These conditions may include:

  • Arterial Occlusion The presence of a blockage in the brachiocephalic artery that impedes blood flow.
  • Stenosis Narrowing of the artery due to plaque buildup, which can lead to reduced blood supply to the right arm and head.
  • Peripheral Vascular Disease A condition that affects blood circulation, often leading to blockages in the arteries.

2. Procedure

The procedure involves several critical steps to ensure successful angioplasty of the brachiocephalic trunk or branches. Each step is essential for achieving the desired outcome of restoring blood flow.

  • Step 1: Preparation and Access The skin over the access artery, typically the brachiocephalic artery, is thoroughly prepped to maintain a sterile environment. A needle is then used to puncture the artery, and a sheath is placed to facilitate the introduction of other instruments.
  • Step 2: Guidewire Insertion A guidewire is inserted through the sheath and advanced into the occluded area of the brachiocephalic trunk or branch. This guidewire serves as a pathway for subsequent devices.
  • Step 3: Balloon Catheter Advancement A catheter with a balloon tip is carefully advanced over the guidewire to the site of the occlusion. This positioning is crucial for the effectiveness of the angioplasty.
  • Step 4: Balloon Inflation Once the balloon catheter is in place, the balloon is inflated. This inflation compresses the plaque against the vessel wall, widening the artery to restore blood flow. The balloon may be inflated multiple times to achieve the desired dilation.
  • Step 5: Angiography Catheter Exchange After the balloon angioplasty, the angioplasty catheter is exchanged for a guidewire. An angiography catheter is then advanced over the guidewire to assess the success of the procedure.
  • Step 6: Completion Angiography Contrast material is injected through the angiography catheter, and completion angiography is performed to visualize the artery and confirm that it is patent.
  • Step 7: Post-Procedure Care The angiography catheter is withdrawn, and pressure is applied to the arterial puncture site to control any bleeding. A pressure dressing is then applied to ensure proper healing and minimize complications.

3. Post-Procedure

Post-procedure care involves monitoring the patient for any signs of complications, such as bleeding or hematoma at the puncture site. The patient may be advised to rest and avoid strenuous activities for a specified period. Follow-up appointments may be scheduled to assess the success of the procedure and ensure the continued patency of the treated artery. Additionally, patients may be instructed on signs and symptoms to watch for that could indicate complications, such as increased pain or swelling in the affected area.

Short Descr REPAIR ARTERIAL BLOCKAGE
Medium Descr TRLUML BALO ANGIOP PRQ BRCH/CPHLC TRNK/BRNCH EA
Long Descr Transluminal balloon angioplasty, percutaneous; brachiocephalic trunk or branches, each vessel
Status Code Restricted Coverage
Global Days 000 - Endoscopic or Minor Procedure
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 9 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P2F - Major procedure, cardiovascular-Other
MUE Not applicable/unspecified.
CCS Clinical Classification 61 - Other OR procedures on vessels other than head and neck
Date
Action
Notes
2017-01-01 Changed Moderate (Conscious) Sedation flag removed. See new Moderate Sedation category.
2016-12-31 Deleted Code deleted. See 36902, 36905, 36907, 37246, 37247, 37248, 37249.
1992-01-01 Added First appearance in code book in 1992.
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