35351 Arterial endarterectomy Medicare reimbursement rates in Missouri

A vascular surgeon uses an open approach to remove atherosclerotic plaque from an iliac artery and improve blood flow through the affected vessel. A patch may be used to close or enlarge the artery; that work is included in the procedure. The service is typically performed in an operating room for symptomatic or limb-threatening occlusive disease when open arterial reconstruction is selected.

Choose this code when the treated artery is iliac, rather than selecting by the general fact that plaque was removed. The operative report should identify the artery and side, describe the plaque removal and any patch work, and support whether one or both sides were treated. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.