CPT® Code 35654

The CPT® Code 35654 refers to a surgical procedure known as a bypass graft, specifically utilizing a synthetic graft rather than a vein. This procedure is performed to create a new pathway for blood flow from the axillary artery to the femoral arteries, which are located in the groin area. The procedure begins with a skin incision made just below the clavicle, allowing access to the axillary artery. Following this, additional incisions are made in the groin area to expose the common femoral arteries on both sides. The surgeon meticulously dissects the soft tissue to access these arteries, ensuring a clear pathway for the graft. A tunnel is then created that connects the axillary artery to the common femoral artery on the same side, facilitating the placement of the graft. In addition to the primary graft, an abdominal tunnel is constructed to accommodate a cross-over graft that connects the femoral artery on one side to the femoral artery on the opposite side. This dual grafting technique is essential for restoring adequate blood flow, particularly in cases where arterial blockages may impede circulation. The procedure involves the careful selection and preparation of a synthetic graft, which is then sutured to the axillary artery and passed through the tunnel to the femoral artery. The surgical team ensures that blood flow is restored by checking the graft's patency using Doppler ultrasound and evaluating distal pulses. This comprehensive approach is critical for patients requiring vascular reconstruction to improve blood flow and prevent complications associated with arterial insufficiency.