CPT® Code 35875

An open thrombectomy of an arterial or venous graft, excluding hemodialysis grafts or fistulas, is a surgical procedure aimed at removing a thrombus, or blood clot, that has formed within the graft. This procedure is necessary when a graft, which is a conduit used to bypass blocked arteries or veins, develops stenosis—a narrowing that can lead to thrombosis and subsequent re-occlusion. The thrombectomy can be performed with or without the need for revision of the graft itself. During the procedure, a surgical incision is made over the graft site, allowing direct access to the graft. Vessel loops are strategically placed both upstream and downstream of the thrombus to manage blood flow during the operation. The surgeon then opens the graft to directly visualize and remove the thrombus, which may involve techniques such as applying arterial back pressure or manual massage to facilitate the expulsion of the clot. After the thrombus is successfully removed, an angiography may be conducted to confirm that the graft is clear of obstructions and remains patent. If stenosis is present, the graft may require revision, which could involve enlarging the narrowed area with a patch graft or replacing it with a tubular graft segment. The appropriate CPT® code for this procedure is 35875 when the thrombectomy is performed without graft revision, while 35876 is used when the procedure includes graft revision.