CPT® Code 35540

A bypass graft is a surgical procedure designed to create an alternative pathway for blood flow around a diseased or obstructed segment of the lower aorta, which is the main artery supplying blood to the lower body. This procedure specifically involves the use of a vein, which can be harvested from the patient or obtained from a donor, to form a graft that connects the aorta to one or both femoral arteries. The surgery is typically performed through a lower abdominal incision, allowing the surgeon to access the aorta directly. During the procedure, clamps are applied to the aorta above the area of obstruction to control blood flow, and the aorta may be tied off to isolate the diseased section. One end of the harvested vein graft is then sutured to the aorta, and a vessel clamp is placed on the venous graft while the aortic clamp is released to check for any leaks at the anastomosis site, which is the junction where the graft is attached. Following this, the femoral artery is clamped distal to the anastomosis site, and the other end of the venous graft is sutured into the iliac artery. The graft site is again assessed for leaks and patency before the abdominal incision is closed. This surgical intervention effectively restores blood flow to the lower extremities by bypassing the obstructed portion of the aorta, thereby alleviating symptoms associated with reduced blood supply, such as pain or claudication. The CPT® code 35540 is specifically designated for this procedure, which involves bypass grafting from the aorta to both femoral vessels, distinguishing it from similar procedures that may involve only one femoral artery.