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CPT®
35548

CPT® Code 35548
Deleted

Code deleted, see 35537, 35539, 35565

Official Description

Bypass graft, with vein; aortoiliofemoral, unilateral

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 35548 refers to a surgical procedure known as a unilateral aortoiliofemoral bypass graft using a vein. This procedure is indicated for patients who have significant arterial obstruction affecting blood flow from the aorta to the iliac and femoral arteries, which can lead to various complications, including limb ischemia. The term "unilateral" indicates that the procedure is performed on one side of the body, specifically addressing the blood flow to one leg. The procedure involves the use of a vein graft, typically harvested from the patient's saphenous vein, to create a bypass around the obstructed segment of the aorta and iliac artery. This surgical intervention aims to restore adequate blood flow to the affected limb, thereby alleviating symptoms such as pain, cramping, or weakness during physical activity. The detailed steps of the procedure involve careful dissection and anastomosis of the graft to ensure proper blood flow and minimize complications. Overall, this procedure is a critical intervention for patients suffering from vascular diseases affecting the lower extremities.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The aortoiliofemoral bypass graft procedure is indicated for patients experiencing significant arterial obstruction that compromises blood flow from the aorta to the iliac and femoral arteries. This condition may manifest through various symptoms, including:

  • Claudication: Pain or cramping in the legs during physical activity due to inadequate blood supply.
  • Rest pain: Persistent pain in the legs or feet while at rest, indicating severe arterial insufficiency.
  • Non-healing wounds or ulcers: Development of sores or ulcers on the legs or feet that do not heal properly due to poor circulation.
  • Gangrene: Tissue death resulting from a lack of blood flow, which may necessitate amputation if not addressed.

2. Procedure

The aortoiliofemoral bypass graft procedure involves several critical steps to ensure successful graft placement and restoration of blood flow. The following procedural steps are performed:

  • Step 1: The abdomen is opened, and the small intestine is mobilized to provide access to the retroperitoneal space.
  • Step 2: The retroperitoneum is opened to expose the aorta, allowing for further dissection.
  • Step 3: The proximal aorta above the obstructed region is carefully dissected free from surrounding tissue to facilitate the placement of a vascular clamp.
  • Step 4: The iliac artery is also dissected free from surrounding tissue to prepare for graft attachment.
  • Step 5: A tunnel is created over the iliac artery for the placement of the vein bypass graft.
  • Step 6: An incision is made over the groin to expose the femoral artery, and a tunnel is created to connect to the femoral artery.
  • Step 7: A vein graft is harvested, typically from the saphenous vein. An incision is made in the leg over the section of the saphenous vein to be harvested, and the soft tissue is dissected off the vein while ligating and dividing branches.
  • Step 8: The section of the saphenous vein to be used is ligated proximally and distally, divided, and removed from the leg.
  • Step 9: A side-biting clamp is placed on the aorta above the obstructed segment, and vascular clamps are applied to the iliac artery above and below the planned incision.
  • Step 10: The aorta is incised, and the first venous graft is sutured to the aorta.
  • Step 11: The vein graft is passed through the tunnel to the iliac artery, where the iliac artery is incised, and the vein graft is anastomosed to the iliac artery.
  • Step 12: Vascular clamps are removed, and hemostasis of the suture lines is checked.
  • Step 13: Vascular clamps are reapplied above and below the planned incision sites in the iliac and femoral arteries.
  • Step 14: A second vein graft is anastomosed to the iliac vein above the diseased portion of the iliac artery, passed through the tunnel to the femoral artery, and anastomosed to the femoral artery.
  • Step 15: Clamps are removed, hemostasis of the suture sites is verified, and blood flow to the extremity is checked.
  • Step 16: The retroperitoneum is closed, followed by closure of the abdomen and groin incisions.

3. Post-Procedure

After the aortoiliofemoral bypass graft procedure, patients are typically monitored for any signs of complications, such as bleeding or infection at the surgical sites. Expected recovery includes a gradual return to normal activities, with specific instructions provided regarding wound care and activity restrictions. Patients may require follow-up appointments to assess the success of the graft and monitor blood flow to the extremities. Pain management and rehabilitation may also be part of the post-procedure care to ensure optimal recovery and functionality.
Short Descr ARTERY BYPASS GRAFT
Medium Descr BYP W/VEIN AORTOILIOFEM UNI
Long Descr Bypass graft, with vein; aortoiliofemoral, unilateral
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) 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) 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 Discontinued Code
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) none
MUE Not applicable/unspecified.
CCS Clinical Classification 55 - Peripheral vascular bypass
Date
Action
Notes
2012-01-01 Deleted Code deleted, see 35537, 35539, 35565
Pre-1990 Added Code added.
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