CPT code 34709: Endograft extension, during initial repair2026 Medicare rate & RVUs in California
Reports placement of an additional endograft extension during infrarenal aortic or iliac endovascular repair to extend the graft's proximal or distal coverage.
CMS doesn’t publish an office rate for 34709 in California.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 34709 covers
During endovascular repair of an infrarenal abdominal aortic or iliac aneurysm or other lesion, the physician may place an additional graft segment to extend the endograft's proximal or distal reach. The extension can help achieve the intended landing zone or seal. Vascular surgeons and other physicians performing endovascular aortic or iliac repair typically use this service in an operating room or endovascular suite. The code includes the associated radiological supervision and interpretation for the extension placement.
Report 34709 with an applicable primary endovascular repair, such as a tube, uniliac, bifurcated, or ilio-iliac graft procedure. The code is per vessel treated, so documentation should identify the vessel receiving an extension and the additional graft placement. CMS classifies it as an add-on code: it is billed only with a primary procedure, and payment falls within that procedure's global period. Do not report it as a stand-alone service; distinguish an extension placed during the repair from a delayed extension addressed by codes 34710 and 34711.
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.
Where 34709 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | Unavailable | $274.12 |
| Chico, CA | Unavailable | $269.82 |
| El Centro, CA | Unavailable | $270.08 |
| Fresno, CA | Unavailable | $269.82 |
| Hanford, CA | Unavailable | $269.82 |
| Los Angeles, CA | Unavailable | $283.76 |
| Madera, CA | Unavailable | $269.82 |
| Marin County, CA | Unavailable | $289.69 |
| Merced, CA | Unavailable | $269.82 |
| Modesto, CA | Unavailable | $269.82 |
| Napa, CA | Unavailable | $283.34 |
| Oxnard, CA | Unavailable | $278.81 |
| Redding, CA | Unavailable | $269.82 |
| Rest of California | Unavailable | $269.82 |
| Riverside, CA | Unavailable | $286.87 |
| Sacramento, CA | Unavailable | $275.43 |
| Salinas, CA | Unavailable | $274.28 |
| San Benito County, CA | Unavailable | $297.72 |
| San Diego, CA | Unavailable | $275.26 |
| San Francisco, CA | Unavailable | $287.89 |
| San Luis Obispo, CA | Unavailable | $270.84 |
| Santa Clara County, CA | Unavailable | $290.34 |
| Santa Cruz, CA | Unavailable | $273.49 |
| Santa Maria, CA | Unavailable | $273.81 |
| Santa Rosa, CA | Unavailable | $275.70 |
| Stockton, CA | Unavailable | $269.82 |
| Vallejo, CA | Unavailable | $280.73 |
| Visalia, CA | Unavailable | $269.82 |
| Yuba City, CA | Unavailable | $269.82 |
How the 34709 rate is calculated
Each of 34709’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 · 34709
RVUs × geographic indexes × conversion factor
Work6.34
6.34 RVUs× 1.000 GPCI
Practice expense0.71
0.71 RVUs× 1.000 GPCI
Malpractice1.59
1.59 RVUs× 1.000 GPCI
Adjusted RVUs
8.6400
Conversion factor
$33.4009
Medicare rate
$288.58
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 34709
The CMS indicators that decide how 34709 is paid alongside other services.
CMS payment indicators · 34709
Endograft extension, during initial repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 2 | Permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 80 · payment effect
With and without the modifier
34709 without 80 · national facility
$288.58
Endograft extension, during initial repair
34709-80 · Assistant: 16%
$46.17
A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.
34709 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 34710Graft extensionDelayed, initial vessel
- 34710 is for delayed placement of an extension in the first vessel. Use 34709 when the extension is placed during the primary endovascular repair.
- 34711Endograft extensionDelayed, additional vessel
- 34711 covers each additional vessel in delayed extension placement. It is not the during-repair extension code.
- 34712Graft fixationEnhanced fixation device
- 34712 describes delivery of an enhanced fixation device. Code 34709 reports placement of an endograft extension to extend graft coverage.
34709 billing questions
When is 34709 used instead of 34710?
Use 34709 for an extension placed during the endovascular repair. Code 34710 describes delayed placement of an extension in the first vessel.
Can 34709 be billed by itself?
No. It is an add-on code and must be reported with an applicable primary endovascular repair.
What should the operative note support?
Document the primary repair, the additional extension placement, and the vessel treated. The record should make clear that the extension was placed during the repair.
How are multiple treated vessels reported?
The code is defined per vessel treated. Documentation should support each vessel for which an extension was placed.
Can the imaging guidance for the extension be billed separately?
The associated radiological supervision and interpretation for the extension placement are included in 34709.
How does CMS treat payment for this code?
CMS identifies 34709 as an add-on code billed only with a primary procedure; its payment is within that procedure's global period.
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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