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CPT®
36834

CPT® Code 36834
Deleted

Official Description

Plastic repair of arteriovenous aneurysm (separate procedure)

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 36834 refers to the plastic repair of an arteriovenous (AV) aneurysm, which is classified as a separate procedure. An arteriovenous aneurysm is an abnormal dilation or bulging of a blood vessel that occurs at the site where an artery and a vein are connected, often as a result of repeated punctures or trauma to the AV fistula. This condition can lead to complications such as increased pressure within the fistula, which may further exacerbate the aneurysm formation. In some cases, the presence of proximal stenosis, or narrowing of the blood vessel upstream, can contribute to the development of an aneurysm by elevating the pressure in the AV fistula. To assess the condition of the AV fistula and the aneurysm, a fistulogram may be performed, which is a diagnostic imaging procedure that helps visualize the blood vessels and identify any stenosis or multiple aneurysms that may be present. The surgical procedure for repairing the aneurysm involves making a longitudinal incision over the aneurysm site while carefully avoiding puncturing the aneurysm itself. The surgeon dissects the aneurysm and completes the skeletonization, which involves isolating the aneurysm from surrounding tissues. Vascular clamps are then applied both proximal and distal to the aneurysm to control blood flow, allowing for the reduction of the aneurysm size. The wall of the aneurysm sac is subsequently plicated, or folded and sutured, along its entire length to reinforce it. Alternatively, the aneurysm may be wrapped in mesh or graft material, which serves to both reduce the size of the aneurysm and provide additional support to the weakened vessel wall.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 36834 is indicated for the repair of an arteriovenous aneurysm, which may arise due to various factors. The following conditions or symptoms may warrant this surgical intervention:

  • Repeated Punctures: Frequent access to the AV fistula for dialysis or other procedures can weaken the vessel wall, leading to aneurysm formation.
  • Proximal Stenosis: Narrowing of the blood vessel upstream can increase pressure within the AV fistula, contributing to the development of an aneurysm.
  • Presence of Multiple Aneurysms: The identification of multiple aneurysms during diagnostic imaging may necessitate surgical repair to prevent complications.

2. Procedure

The procedure for the plastic repair of an arteriovenous aneurysm involves several critical steps, each aimed at ensuring the effective treatment of the aneurysm while minimizing risks. The following procedural steps are performed:

  • Step 1: Incision A longitudinal incision is made in the skin and soft tissues directly over the site of the aneurysm. Care is taken to avoid puncturing the aneurysm itself during this initial step, as this could lead to complications.
  • Step 2: Dissection The surgeon carefully dissects the aneurysm, completing the skeletonization process. This involves isolating the aneurysm from the surrounding tissues to provide clear access for repair.
  • Step 3: Vascular Clamping Vascular clamps are applied both proximal and distal to the aneurysm. This step is crucial as it controls blood flow to the area, allowing the surgeon to work on the aneurysm without excessive bleeding.
  • Step 4: Aneurysm Reduction Once the clamps are in place, the size of the aneurysm is reduced. This may involve suturing or other techniques to decrease the bulging of the vessel.
  • Step 5: Plication of the Aneurysm Wall The wall of the aneurysm sac is plicated with sutures along its entire length. This step reinforces the vessel wall and helps restore its integrity.
  • Step 6: Alternative Repair Method In some cases, instead of plicating the wall, the aneurysm may be wrapped in mesh or graft material. This alternative method provides additional support and reinforcement to the weakened wall of the aneurysm.

3. Post-Procedure

After the completion of the procedure, post-operative care is essential for ensuring proper recovery and monitoring for any potential complications. Patients may be observed for signs of bleeding or infection at the incision site. Follow-up imaging may be necessary to assess the success of the repair and to ensure that no new aneurysms have formed. Patients are typically advised on activity restrictions and may require follow-up appointments to monitor the function of the AV fistula and overall vascular health.
Short Descr REPAIR A-V ANEURYSM
Medium Descr REPAIR A-V ANEURYSM
Long Descr PLSTC RPR ARVEN ARYSM SPX
APC Status Indicator Significant Procedure, Multiple Reduction Applies
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) none
MUE Not applicable/unspecified.
CCS Clinical Classification 57 - Creation, revision and removal of arteriovenous fistula or vessel-to-vessel cannula for dialysis
Date
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Notes
2010-01-01 Deleted -
1995-01-01 Added Code added.
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