CPT code 34520: Venous bypass, femoral-femoral crossover graft2026 Medicare rate & RVUs in Montana
Reports a surgically created crossover vein graft that reroutes lower-extremity venous blood flow around an obstruction into the opposite-side venous system.
In Montana, Medicare pays $902.84 for 34520 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 34520 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 34520 covers
A vascular surgeon creates a vein-graft pathway across the midline to reroute blood from an obstructed lower-extremity venous outflow into the opposite-side venous system. A typical clinical setting is chronic unilateral iliac venous obstruction when a crossover bypass, such as a Palma-Dale-type operation, is selected. The operative record should identify the obstruction, the veins used for inflow and outflow, the graft route, and the anastomoses.
Report this code for the crossover venous graft procedure, not simply for vein harvest or a valve repair. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. A bilateral procedure reported with modifier 50 is paid at 150%. Assistant-at-surgery services may be paid; co-surgeons are paid only with supporting documentation. Team surgery is not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
How Montana compares for 34520
Across 109 of 109 payment localities, the facility rate for 34520 runs from $787.90 in Wisconsin to $1,151.67 in Alaska. Montana pays $902.84. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Montana · this page$902.84
- Los Angeles, CA · California$897.06−$5.78
- Washington, DC area · District of Columbia$976.12+$73.28
- Miami, FL · Florida$1,151.65+$248.81
- Chicago, IL · Illinois$1,114.45+$211.61
- Manhattan, NY · New York$1,055.81+$152.97
- Alaska · Alaska$1,151.67+$248.83
Other areas in Montana first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $819.11 |
| ArkansasArkansas | — | $809.08 |
| ArizonaArizona | — | $876.52 |
| Bakersfield, CACalifornia | — | $864.18 |
| Chico, CACalifornia | — | $851.30 |
| El Centro, CACalifornia | — | $852.10 |
| Fresno, CACalifornia | — | $851.30 |
| Hanford, CACalifornia | — | $851.30 |
| Madera, CACalifornia | — | $851.30 |
| Merced, CACalifornia | — | $851.30 |
| Modesto, CACalifornia | — | $851.30 |
| Napa, CACalifornia | — | $902.04 |
| Oxnard, CACalifornia | — | $882.29 |
| Redding, CACalifornia | — | $851.30 |
| Rest of CaliforniaCalifornia | — | $851.30 |
| Riverside, CACalifornia | — | $902.43 |
| Sacramento, CACalifornia | — | $871.16 |
| Salinas, CACalifornia | — | $867.56 |
| San Diego, CACalifornia | — | $872.30 |
| Marin County, CACalifornia | — | $925.19 |
| San Francisco, CACalifornia | — | $919.78 |
| San Benito County, CACalifornia | — | $950.65 |
| Santa Clara County, CACalifornia | — | $928.50 |
| San Luis Obispo, CACalifornia | — | $856.43 |
| Santa Cruz, CACalifornia | — | $867.99 |
| Santa Maria, CACalifornia | — | $866.52 |
| Santa Rosa, CACalifornia | — | $875.16 |
| Stockton, CACalifornia | — | $851.30 |
| Vallejo, CACalifornia | — | $894.24 |
| Visalia, CACalifornia | — | $851.30 |
| Yuba City, CACalifornia | — | $851.30 |
| ColoradoColorado | — | $883.40 |
| ConnecticutConnecticut | — | $958.29 |
| DelawareDelaware | — | $888.76 |
| Fort Lauderdale, FLFlorida | — | $1,033.44 |
| Rest of FloridaFlorida | — | $978.05 |
| Atlanta, GAGeorgia | — | $938.97 |
| Rest of GeorgiaGeorgia | — | $920.87 |
| Hawaii, Guam, HIHawaii | — | $852.42 |
| IowaIowa | — | $796.95 |
| IdahoIdaho | — | $809.66 |
| East St. Louis, ILIllinois | — | $1,055.17 |
| Rest of IllinoisIllinois | — | $982.48 |
| Suburban Chicago, ILIllinois | — | $1,033.75 |
| IndianaIndiana | — | $812.56 |
| KansasKansas | — | $812.69 |
| KentuckyKentucky | — | $876.38 |
| New Orleans, LALouisiana | — | $917.79 |
| Rest of LouisianaLouisiana | — | $882.76 |
| Metropolitan Boston, MAMassachusetts | — | $934.38 |
| Rest of MassachusettsMassachusetts | — | $887.13 |
| Baltimore area, MDMaryland | — | $959.62 |
| Rest of MarylandMaryland | — | $897.77 |
| Rest of MaineMaine | — | $833.40 |
| Southern Maine, MEMaine | — | $843.30 |
| Detroit, MIMichigan | — | $1,008.28 |
| Rest of MichiganMichigan | — | $913.34 |
| MinnesotaMinnesota | — | $794.46 |
| Metropolitan Kansas City, MOMissouri | — | $892.22 |
| Metropolitan St. Louis, MOMissouri | — | $897.76 |
| Rest of MissouriMissouri | — | $882.56 |
| MississippiMississippi | — | $845.00 |
| North CarolinaNorth Carolina | — | $837.66 |
| North DakotaNorth Dakota | — | $808.52 |
| NebraskaNebraska | — | $794.88 |
| New HampshireNew Hampshire | — | $888.13 |
| Northern New JerseyNew Jersey | — | $972.42 |
| Rest of New JerseyNew Jersey | — | $954.57 |
| New MexicoNew Mexico | — | $925.29 |
| NevadaNevada | — | $876.67 |
| NYC suburbs and Long Island, NYNew York | — | $1,102.21 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $976.05 |
| Queens, NYNew York | — | $1,035.26 |
| Rest of New YorkNew York | — | $849.88 |
| OhioOhio | — | $894.06 |
| OklahomaOklahoma | — | $854.87 |
| Portland, OROregon | — | $885.60 |
| Rest of OregonOregon | — | $855.36 |
| Metropolitan Philadelphia, PAPennsylvania | — | $950.04 |
| Rest of PennsylvaniaPennsylvania | — | $884.62 |
| Puerto RicoPuerto Rico | — | $902.08 |
| Rhode IslandRhode Island | — | $901.76 |
| South CarolinaSouth Carolina | — | $870.20 |
| South DakotaSouth Dakota | — | $797.37 |
| TennesseeTennessee | — | $818.54 |
| Austin, TXTexas | — | $893.16 |
| Beaumont, TXTexas | — | $881.12 |
| Brazoria, TXTexas | — | $872.03 |
| Dallas, TXTexas | — | $885.68 |
| Fort Worth, TXTexas | — | $886.56 |
| Galveston, TXTexas | — | $879.92 |
| Houston, TXTexas | — | $967.23 |
| Rest of TexasTexas | — | $881.62 |
| UtahUtah | — | $879.75 |
| VirginiaVirginia | — | $854.29 |
| Virgin Islands, VIUnited States Virgin Islands | — | $902.08 |
| VermontVermont | — | $823.26 |
| Rest of WashingtonWashington | — | $879.52 |
| King County, WAWashington | — | $932.30 |
| WisconsinWisconsin | — | $787.90 |
| West VirginiaWest Virginia | — | $956.21 |
| WyomingWyoming | — | $861.74 |
34520 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
How the 34520 rate is calculated
Each of 34520’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 34520
RVUs × geographic indexes × conversion factor
Work18.70
18.70 RVUs× 1.000 GPCI
Practice expense3.57
3.57 RVUs× 1.000 GPCI
Malpractice4.77
4.77 RVUs× 1.000 GPCI
Adjusted RVUs
27.0400
Conversion factor
$33.4009
Medicare rate
$903.16
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Montana inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
4,198
- Code
- 34520
- Physician work
- 18.70
- Practice expense
- 3.57
- Malpractice
- 4.77
GPCI2026.csv
71
- Locality
- Montana
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.998
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 18.70 | × 1.000 | 18.7000 |
| Practice expense | 3.57 | × 1.000 | 3.5700 |
| Malpractice | 4.77 | × 0.998 | 4.7605 |
| Total RVUs | 27.0305 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Montana$902.84
Facility: (18.7 × 1 + 3.57 × 1 + 4.77 × 0.998) × $33.4009 = $902.84
Payment rules and modifiers for 34520
34520 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 34520
Venous bypass, femoral-femoral crossover graft
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.84/0.07 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 34520
Venous bypass, femoral-femoral crossover graft
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
34520 without 50 · national facility
$903.16
Venous bypass, femoral-femoral crossover graft
34520-50 · Bilateral: 150%
$1,354.74
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
How 34520 has changed in Montana
34520 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $902.84 | RVU26D |
| 2026-07-01 | Not available in this setting | $902.84 | RVU26C |
| 2026-04-01 | Not available in this setting | $902.84 | RVU26B |
| 2026-01-01 | Not available in this setting | $902.84 | RVU26A |
| 2025-10-01 | Not available in this setting | $939.53 | RVU25D |
| 2025-07-01 | Not available in this setting | $939.53 | RVU25C |
| 2025-04-01 | Not available in this setting | $939.53 | RVU25B |
| 2025-01-01 | Not available in this setting | $939.53 | RVU25A |
| 2024-10-01 | Not available in this setting | $962.86 | RVU24D |
| 2024-07-01 | Not available in this setting | $962.86 | RVU24C |
| 2024-04-01 | Not available in this setting | $962.86 | RVU24B |
| 2024-03-09 | Not available in this setting | $962.86 | RVU24AR |
| 2024-01-01 | Not available in this setting | $947.14 | RVU24A |
| 2023-10-01 | Not available in this setting | $976.54 | RVU23D |
| 2023-07-01 | Not available in this setting | $976.54 | RVU23C |
| 2023-04-01 | Not available in this setting | $976.54 | RVU23B |
| 2023-01-01 | Not available in this setting | $976.54 | RVU23A |
| 2022-10-01 | Not available in this setting | $999.78 | RVU22D |
| 2022-07-01 | Not available in this setting | $999.78 | RVU22C |
| 2022-04-01 | Not available in this setting | $999.78 | RVU22B |
| 2022-01-01 | Not available in this setting | $999.78 | RVU22A |
| 2021-10-01 | Not available in this setting | $998.09 | RVU21D |
| 2021-07-01 | Not available in this setting | $998.09 | RVU21C |
| 2021-04-01 | Not available in this setting | $998.09 | RVU21B |
| 2021-01-01 | Not available in this setting | $998.09 | RVU21A |
| 2020-10-01 | Not available in this setting | $1,086.71 | RVU20D |
| 2020-07-01 | Not available in this setting | $1,086.71 | RVU20C |
| 2020-04-01 | Not available in this setting | $1,086.71 | RVU20B |
| 2020-01-01 | Not available in this setting | $1,086.71 | RVU20A |
| 2019-10-01 | Not available in this setting | $1,129.16 | RVU19D |
| 2019-07-01 | Not available in this setting | $1,129.16 | RVU19C |
| 2019-04-01 | Not available in this setting | $1,115.64 | RVU19B |
| 2019-01-01 | Not available in this setting | $1,115.64 | RVU19A |
| 2018-10-01 | Not available in this setting | $1,132.78 | RVU18D |
| 2018-07-01 | Not available in this setting | $1,132.78 | RVU18C |
| 2018-04-01 | Not available in this setting | $1,132.78 | RVU18B |
| 2018-01-01 | Not available in this setting | $1,132.78 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $1,169.73 | RVU17D |
| 2017-07-01 | Not available in this setting | $1,169.73 | RVU17C |
| 2017-04-01 | Not available in this setting | $1,169.73 | RVU17B |
| 2017-01-01 | Not available in this setting | $1,169.73 | RVU17A |
| 2016-10-01 | Not available in this setting | $1,096.84 | RVU16D |
| 2016-07-01 | Not available in this setting | $1,096.84 | RVU16C |
| 2016-04-01 | Not available in this setting | $1,096.84 | RVU16B |
| 2016-01-01 | Not available in this setting | $1,096.84 | RVU16A |
| 2015-10-01 | Not available in this setting | $1,089.56 | RVU15D |
| 2015-07-01 | Not available in this setting | $1,089.56 | RVU15C |
| 2015-04-01 | Not available in this setting | $1,084.14 | RVU15B |
| 2015-01-01 | Not available in this setting | $1,084.14 | RVU15A |
| 2014-10-01 | Not available in this setting | $1,081.05 | RVU14D |
| 2014-07-01 | Not available in this setting | $1,081.05 | RVU14C |
| 2014-04-01 | Not available in this setting | $1,081.05 | RVU14B |
| 2014-01-01 | Not available in this setting | $1,081.05 | RVU14A |
| 2013-10-01 | Not available in this setting | $1,052.29 | RVU13D |
| 2013-07-01 | Not available in this setting | $1,052.29 | RVU13C |
| 2013-04-01 | Not available in this setting | $1,052.29 | RVU13B |
| 2013-01-01 | Not available in this setting | $1,052.29 | RVU13AR |
Where the Montana rate applies
Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.
- Absarokee
- Acton
- Alberton
- Alder
- Alzada
- Amsterdam
- Anaconda-Deer Lodge County
- Antelope
34520 billing questions
When is this code appropriate instead of a venous valve procedure?
Use it for a crossover vein graft that reroutes lower-extremity venous flow. Codes 34501 and 34510 describe procedures directed at a femoral vein valve.
Does a crossover graft automatically require modifier 50?
No. The graft crosses between sides as part of the procedure; that fact alone does not make the service bilateral. CMS pays a bilateral procedure reported with modifier 50 at 150%.
What operative details support reporting this code?
Document the venous obstruction, the inflow and outflow vessels, the graft route across the midline, and the anastomoses. The record should establish that a crossover graft was created.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period. The period applies to care related to this major surgery.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeons are paid only when supporting documentation is submitted; team surgery is not permitted.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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