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Dr Z or Dr Dunn, Patient has descending thoracic aortic aneurysm. Patient is an endovascular candidate but upon review of imaging it was apparent that patient could not do ileofemoral access. So an retroperitoneal approach to the infrarenal aorta with direct aortic access for conduit purposes would be necessary. Open access of retroperitoneal plane and access to the infrarenal aorta was obtained. Also, percutaneous access to right common femoral artery was obtained with cath to aorta for diagnostic imaging of the of arch and thoracic artery. Medtronic Tallent thoracic graft with delivery system is placed from the aortic access along with two distal extensions just proximal to the celiac axis. After placement of thoracic graft retroperitoneum was closed and R femoral puncture site was closed. I'm not sure what codes to use for this case. 33881 75957 are endovascular codes and clearly the graft was placed through the aortic access. The only artery exposure codes with creation of conduit I can find are 34833 (iliac artery) 34834 (brachial) which does not fit in this case. Any help in coding this case would be very much appreciated.