CPT® Code 61692

An arteriovenous malformation (AVM) is a pathological condition characterized by an abnormal connection between the arterial and venous systems, where one or more arteries and veins connect directly without the intermediary of capillaries. This congenital malformation can occur in various locations within the body, but when it is intracranial, it poses significant risks due to the high-pressure shunting of blood directly into the venous system. Such shunting can lead to serious complications, including the potential for rupture of blood vessels, resulting in hemorrhage and other neurological issues. The surgical procedure described by CPT® Code 61692 specifically addresses the surgical intervention for complex dural AVMs, which are located within the dura mater—the tough, fibrous outer membrane that encases the central nervous system. The surgery involves a craniotomy, where scalp flaps are created, burr holes are drilled, and a bone flap is elevated to access the AVM. The procedure requires meticulous dissection to expose the AVM, followed by the identification and ligation of arterial feeders and draining veins. The complete excision of the AVM is critical to prevent further complications, and post-operative angiography is performed to confirm the successful removal of the malformation. This procedure is distinct from simpler AVMs, which are smaller and typically do not involve normal vessels or critical brain regions.