CPT® Code 35870

The procedure described by CPT® Code 35870 refers to the surgical intervention known as the repair of a graft-enteric fistula. A graft-enteric fistula is an abnormal connection that forms between a vascular graft, typically one used for abdominal aortic repair, and the gastrointestinal tract, most commonly the duodenum. This condition can also arise between other abdominal artery grafts and sections of the bowel. The surgical approach involves a thorough exploration of the abdomen, where the surgeon carefully dissects the bowel away from the graft to prevent further complications. The identification of the fistula is a critical step in the procedure, as it allows for the appropriate management of the abnormal connection. Prior to the actual repair of the fistula, a separate aortic or arterial bypass procedure is usually performed, which is reported separately for billing purposes. Following the identification and removal of the graft, the surgeon proceeds to repair the affected section of the bowel. To mitigate the risk of recurrence of the fistula, omentum—a fold of peritoneum—may be placed between the newly repaired bowel and the graft. This procedure is essential for restoring normal bowel function and preventing further complications associated with graft-enteric fistulas.