CPT® Code 35621

An axillary-femoral bypass graft, coded as CPT® 35621, is a surgical procedure designed to reroute blood flow around a diseased or obstructed segment of the aorta, iliac, or femoral artery using a synthetic graft rather than a vein. This procedure is indicated when there is significant arterial blockage that impairs blood circulation, potentially leading to complications such as limb ischemia. The operation begins with a skin incision made in the chest area, just below the clavicle, allowing access to the proximal axillary artery. A second incision is then made in the groin region over the common femoral artery or in the leg over the popliteal or tibial artery, facilitating exposure of the affected arteries. The surgeon creates a tunnel that connects the axillary artery to the common femoral artery, or extends to the popliteal or tibial artery if an axillary-popliteal/-tibial bypass is performed. A synthetic graft is selected and sutured to the axillary artery, then passed through the tunnel to connect with the distal artery. This procedure is critical for restoring adequate blood flow to the lower extremities, thereby improving patient outcomes and quality of life.