CPT code 35355: Arterial endarterectomy, iliac artery2026 Medicare rate & RVUs in Guam
Open iliac artery endarterectomy removes obstructive plaque to restore blood flow, with patch repair included when performed.
CMS doesn’t publish an office rate for 35355 in Guam.
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 35355 covers
This code describes open removal of atherosclerotic plaque from an iliac artery to improve blood flow. The vascular surgeon exposes the affected artery, clears the obstructing material, and may use a patch to widen or repair the vessel. It is typically performed in a hospital or other facility for clinically significant iliac artery disease, such as occlusive disease causing impaired lower-extremity circulation.
Report the code when the operative record supports endarterectomy of the iliac artery; a patch, when used, is included in the service. The record should identify the treated artery, the plaque removal, and any repair performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be allowed; co-surgeons require supporting documentation, and 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.
35355 in Hawaii, Guam, HI
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam, HI | Unavailable | $879.84 |
How the 35355 rate is calculated
Each of 35355’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 · 35355
RVUs × geographic indexes × conversion factor
Work19.36
19.36 RVUs× 1.000 GPCI
Practice expense3.63
3.63 RVUs× 1.000 GPCI
Malpractice4.93
4.93 RVUs× 1.000 GPCI
Adjusted RVUs
27.9200
Conversion factor
$33.4009
Medicare rate
$932.55
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 35355
35355 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 35355
Arterial endarterectomy, iliac artery
| 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 · 35355
Arterial endarterectomy, iliac artery
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
35355 without 50 · national facility
$932.55
Arterial endarterectomy, iliac artery
35355-50 · Bilateral: 150%
$1,398.83
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).
35355 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 35351Arterial endarterectomyIliac artery
- 35355 is for iliac artery endarterectomy; 35351 applies to a different arterial site. Base selection on the artery treated in the operative report.
- 35361Arterial endarterectomyAorta
- Use 35355 for iliac artery treatment; 35361 represents aortoiliac endarterectomy. The documented operative extent determines the appropriate code.
- 35371Arterial endarterectomyFemoral, profunda, or popliteal
- 35371 is for femoral artery endarterectomy, whereas 35355 is for the iliac artery. Do not choose by the general diagnosis of lower-extremity occlusive disease alone.
35355 billing questions
When should 35355 be selected instead of a neighboring endarterectomy code?
Use 35355 when the operative service is endarterectomy of the iliac artery. Select a different site-specific code when the treated artery is the aorta or a femoral artery.
Is patch angioplasty separately reported?
A patch used as part of the iliac endarterectomy is included in this code. The operative report should describe the patch when one is used.
How does Medicare handle bilateral reporting?
For a bilateral procedure, report modifier 50; CMS pays the bilateral service at 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be allowed. Co-surgeons are paid only with supporting documentation; team surgery is not permitted.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
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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