Medicare Benefits Schedule - Note TN.8.36

Vascular surgery items have been constructed on the basis that arteriotomy and venotomy wounds are closed by simple suture without the use of a patch. 

Where a patch angioplasty is used to enlarge a narrowed vein, artery or arteriovenous fistula, the correct item would be 34815 or 34518. If the vein is harvested for the patch through a separate incision, Item 33551 would also apply, in accordance with the multiple operation rule. 

If a patch graft is involved in conjunction with an operative procedure included in Items 33500 - 33542, 33803, 33806, 33815, 33833 or 34142, the patch graft would attract benefits under Item 33545 or 33548 in addition to the item for the primary operation (under the multiple operation rule). Where vein is harvested for the patch through a separate incision Item 33551 would also apply.

Related Items: 33545 33548 33551 34815

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Multiple Operation Rule

ARTERY, VEIN OR BYPASS GRAFT, patch grafting to by vein or synthetic material where patch is less than 3cm long

(Anaes.) (Assist.)

Fee: $301.20 Benefit: 75% = $225.90

(See para TN.8.36 of explanatory notes to this Category)

Multiple Operation Rule

ARTERY, VEIN OR BYPASS GRAFT, patch grafting to by vein or synthetic material where patch is 3cm long or greater

(Anaes.) (Assist.)

Fee: $612.65 Benefit: 75% = $459.50

(See para TN.8.36 of explanatory notes to this Category)

Multiple Operation Rule

VEIN, harvesting of from leg or arm for patch when not performed through same incision as operation

(Anaes.) (Assist.)

Fee: $301.20 Benefit: 75% = $225.90

(See para TN.8.36 of explanatory notes to this Category)

Multiple Operation Rule

VEIN STENOSIS, patch angioplasty for, (excluding vein graft stenosis)-using vein or synthetic material

(Anaes.) (Assist.)

Fee: $1,067.70 Benefit: 75% = $800.80

(See para TN.8.36 of explanatory notes to this Category)