CPT code 35506: Arterial bypass, subclavian to carotid2026 Medicare rate & RVUs in Napa, CA
Reports an open graft bypass from the subclavian artery to the carotid artery, typically to reroute blood flow around obstructive disease.
In Napa, CA, Medicare pays $1,146.49 for 35506 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 35506 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 35506 covers
This open vascular operation creates a graft route between the subclavian and carotid arteries to bypass an obstructed segment and restore blood flow. Vascular surgeons most often perform it in a hospital operating room for proximal subclavian artery disease associated with arm ischemia or subclavian steal. The operative report should identify the bypass origin and target, the reason for rerouting flow, and the graft procedure performed.
Report 35506 when the completed bypass runs from the subclavian artery to the carotid artery; select a neighboring bypass code when the documented endpoints differ. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons are paid only with 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.
How Napa, CA compares for 35506
Across 109 of 109 payment localities, the facility rate for 35506 runs from $1,007.99 in Wisconsin to $1,486.32 in Miami, FL. Napa, CA pays $1,146.49. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Napa, CA · this page$1,146.49
- Bakersfield, CA · California$1,104.11−$42.38
- Chico, CA · California$1,087.08−$59.41
- El Centro, CA · California$1,088.13−$58.36
- Fresno, CA · California$1,087.08−$59.41
- Hanford, CA · California$1,087.08−$59.41
- Los Angeles, CA · California$1,144.58−$1.91
Other areas in California first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| Madera, CACalifornia | — | $1,087.08 |
| Merced, CACalifornia | — | $1,087.08 |
| Modesto, CACalifornia | — | $1,087.08 |
| Oxnard, CACalifornia | — | $1,125.09 |
| Redding, CACalifornia | — | $1,087.08 |
| Rest of CaliforniaCalifornia | — | $1,087.08 |
| Riverside, CACalifornia | — | $1,154.71 |
| Sacramento, CACalifornia | — | $1,111.01 |
| Salinas, CACalifornia | — | $1,106.39 |
| San Diego, CACalifornia | — | $1,111.39 |
| Marin County, CACalifornia | — | $1,173.90 |
| San Francisco, CACalifornia | — | $1,166.73 |
| San Benito County, CACalifornia | — | $1,206.45 |
| Santa Clara County, CACalifornia | — | $1,177.15 |
| San Luis Obispo, CACalifornia | — | $1,092.38 |
| Santa Cruz, CACalifornia | — | $1,105.04 |
| Santa Maria, CACalifornia | — | $1,104.78 |
| Santa Rosa, CACalifornia | — | $1,114.07 |
| Stockton, CACalifornia | — | $1,087.08 |
| Vallejo, CACalifornia | — | $1,136.16 |
| Visalia, CACalifornia | — | $1,087.08 |
| Yuba City, CACalifornia | — | $1,087.08 |
| Washington, DC areaDistrict of Columbia | — | $1,249.32 |
| Miami, FLFlorida | — | $1,486.32 |
| Chicago, ILIllinois | — | $1,438.34 |
| Manhattan, NYNew York | — | $1,355.28 |
| AlaskaAlaska | — | $1,484.89 |
| AlabamaAlabama | — | $1,052.14 |
| ArkansasArkansas | — | $1,039.41 |
| ArizonaArizona | — | $1,124.84 |
| ColoradoColorado | — | $1,130.64 |
| ConnecticutConnecticut | — | $1,229.26 |
| DelawareDelaware | — | $1,140.37 |
| Fort Lauderdale, FLFlorida | — | $1,330.91 |
| Rest of FloridaFlorida | — | $1,259.60 |
| Atlanta, GAGeorgia | — | $1,205.82 |
| Rest of GeorgiaGeorgia | — | $1,186.17 |
| Hawaii, Guam, HIHawaii | — | $1,087.17 |
| IowaIowa | — | $1,021.45 |
| IdahoIdaho | — | $1,038.08 |
| East St. Louis, ILIllinois | — | $1,362.86 |
| Rest of IllinoisIllinois | — | $1,266.95 |
| Suburban Chicago, ILIllinois | — | $1,330.82 |
| IndianaIndiana | — | $1,041.68 |
| KansasKansas | — | $1,042.64 |
| KentuckyKentucky | — | $1,127.42 |
| New Orleans, LALouisiana | — | $1,180.40 |
| Rest of LouisianaLouisiana | — | $1,135.99 |
| Metropolitan Boston, MAMassachusetts | — | $1,193.56 |
| Rest of MassachusettsMassachusetts | — | $1,135.96 |
| Baltimore area, MDMaryland | — | $1,231.16 |
| Rest of MarylandMaryland | — | $1,151.46 |
| Rest of MaineMaine | — | $1,069.48 |
| Southern Maine, MEMaine | — | $1,080.13 |
| Detroit, MIMichigan | — | $1,299.28 |
| Rest of MichiganMichigan | — | $1,175.48 |
| MinnesotaMinnesota | — | $1,014.21 |
| Metropolitan Kansas City, MOMissouri | — | $1,146.65 |
| Metropolitan St. Louis, MOMissouri | — | $1,153.52 |
| Rest of MissouriMissouri | — | $1,136.52 |
| MississippiMississippi | — | $1,086.87 |
| MontanaMontana | — | $1,158.59 |
| North CarolinaNorth Carolina | — | $1,074.67 |
| North DakotaNorth Dakota | — | $1,033.82 |
| NebraskaNebraska | — | $1,018.43 |
| New HampshireNew Hampshire | — | $1,137.72 |
| Northern New JerseyNew Jersey | — | $1,245.04 |
| Rest of New JerseyNew Jersey | — | $1,223.79 |
| New MexicoNew Mexico | — | $1,191.14 |
| NevadaNevada | — | $1,123.94 |
| NYC suburbs and Long Island, NYNew York | — | $1,415.73 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $1,252.10 |
| Queens, NYNew York | — | $1,327.40 |
| Rest of New YorkNew York | — | $1,090.25 |
| OhioOhio | — | $1,149.97 |
| OklahomaOklahoma | — | $1,098.82 |
| Portland, OROregon | — | $1,131.94 |
| Rest of OregonOregon | — | $1,095.92 |
| Metropolitan Philadelphia, PAPennsylvania | — | $1,219.59 |
| Rest of PennsylvaniaPennsylvania | — | $1,137.31 |
| Puerto RicoPuerto Rico | — | $1,157.21 |
| Rhode IslandRhode Island | — | $1,155.99 |
| South CarolinaSouth Carolina | — | $1,118.03 |
| South DakotaSouth Dakota | — | $1,019.07 |
| TennesseeTennessee | — | $1,050.21 |
| Austin, TXTexas | — | $1,143.78 |
| Beaumont, TXTexas | — | $1,132.95 |
| Brazoria, TXTexas | — | $1,118.13 |
| Dallas, TXTexas | — | $1,136.02 |
| Fort Worth, TXTexas | — | $1,137.52 |
| Galveston, TXTexas | — | $1,128.50 |
| Houston, TXTexas | — | $1,243.99 |
| Rest of TexasTexas | — | $1,132.28 |
| UtahUtah | — | $1,130.12 |
| VirginiaVirginia | — | $1,094.95 |
| Virgin Islands, VIUnited States Virgin Islands | — | $1,157.21 |
| VermontVermont | — | $1,053.66 |
| Rest of WashingtonWashington | — | $1,125.90 |
| King County, WAWashington | — | $1,189.67 |
| WisconsinWisconsin | — | $1,007.99 |
| West VirginiaWest Virginia | — | $1,233.70 |
| WyomingWyoming | — | $1,104.21 |
35506 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 35506 rate is calculated
Each of 35506’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 · 35506
RVUs × geographic indexes × conversion factor
Work24.70
24.70 RVUs× 1.000 GPCI
Practice expense3.69
3.69 RVUs× 1.000 GPCI
Malpractice6.31
6.31 RVUs× 1.000 GPCI
Adjusted RVUs
34.7000
Conversion factor
$33.4009
Medicare rate
$1,159.01
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Napa, CA inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
4,332
- Code
- 35506
- Physician work
- 24.70
- Practice expense
- 3.69
- Malpractice
- 6.31
GPCI2026.csv
17
- Locality
- Napa, CA
- Physician work
- 1.063
- Practice expense
- 1.318
- Malpractice
- 0.508
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 24.70 | × 1.063 | 26.2561 |
| Practice expense | 3.69 | × 1.318 | 4.8634 |
| Malpractice | 6.31 | × 0.508 | 3.2055 |
| Total RVUs | 34.3250 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Napa, CA$1146.49
Facility: (24.7 × 1.063 + 3.69 × 1.318 + 6.31 × 0.508) × $33.4009 = $1146.49
Payment rules and modifiers for 35506
35506 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 35506
Arterial bypass, subclavian to carotid
| 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 · 35506
Arterial bypass, subclavian to carotid
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
35506 without 50 · national facility
$1,159.01
Arterial bypass, subclavian to carotid
35506-50 · Bilateral: 150%
$1,738.52
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 35506 has changed in Napa, CA
35506 · 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 | $1,146.49 | RVU26D |
| 2026-07-01 | Not available in this setting | $1,146.49 | RVU26C |
| 2026-04-01 | Not available in this setting | $1,146.49 | RVU26B |
| 2026-01-01 | Not available in this setting | $1,146.49 | RVU26A |
| 2025-10-01 | Not available in this setting | $1,219.40 | RVU25D |
| 2025-07-01 | Not available in this setting | $1,219.40 | RVU25C |
| 2025-04-01 | Not available in this setting | $1,219.40 | RVU25B |
| 2025-01-01 | Not available in this setting | $1,219.40 | RVU25A |
| 2024-10-01 | Not available in this setting | $1,248.59 | RVU24D |
| 2024-07-01 | Not available in this setting | $1,248.59 | RVU24C |
| 2024-04-01 | Not available in this setting | $1,248.59 | RVU24B |
| 2024-03-09 | Not available in this setting | $1,248.59 | RVU24AR |
| 2024-01-01 | Not available in this setting | $1,228.21 | RVU24A |
| 2023-10-01 | Not available in this setting | $1,251.94 | RVU23D |
| 2023-07-01 | Not available in this setting | $1,251.94 | RVU23C |
| 2023-04-01 | Not available in this setting | $1,251.94 | RVU23B |
| 2023-01-01 | Not available in this setting | $1,251.94 | RVU23A |
| 2022-10-01 | Not available in this setting | $1,264.09 | RVU22D |
| 2022-07-01 | Not available in this setting | $1,264.09 | RVU22C |
| 2022-04-01 | Not available in this setting | $1,264.09 | RVU22B |
| 2022-01-01 | Not available in this setting | $1,264.09 | RVU22A |
| 2021-10-01 | Not available in this setting | $1,266.02 | RVU21D |
| 2021-07-01 | Not available in this setting | $1,266.02 | RVU21C |
| 2021-04-01 | Not available in this setting | $1,266.02 | RVU21B |
| 2021-01-01 | Not available in this setting | $1,266.02 | RVU21A |
| 2020-10-01 | Not available in this setting | $1,317.98 | RVU20D |
| 2020-07-01 | Not available in this setting | $1,317.98 | RVU20C |
| 2020-04-01 | Not available in this setting | $1,317.98 | RVU20B |
| 2020-01-01 | Not available in this setting | $1,317.98 | RVU20A |
| 2019-10-01 | Not available in this setting | $1,313.86 | RVU19D |
| 2019-07-01 | Not available in this setting | $1,313.86 | RVU19C |
| 2019-04-01 | Not available in this setting | $1,311.39 | RVU19B |
| 2019-01-01 | Not available in this setting | $1,311.39 | RVU19A |
| 2018-10-01 | Not available in this setting | $1,323.52 | RVU18D |
| 2018-07-01 | Not available in this setting | $1,323.52 | RVU18C |
| 2018-04-01 | Not available in this setting | $1,323.52 | RVU18B |
| 2018-01-01 | Not available in this setting | $1,323.52 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $1,346.46 | RVU17D |
| 2017-07-01 | Not available in this setting | $1,346.46 | RVU17C |
| 2017-04-01 | Not available in this setting | $1,346.46 | RVU17B |
| 2017-01-01 | Not available in this setting | $1,346.46 | RVU17A |
| 2016-10-01 | Not available in this setting | Rate data unavailable | RVU16D |
| 2016-07-01 | Not available in this setting | Rate data unavailable | RVU16C |
| 2016-04-01 | Not available in this setting | Rate data unavailable | RVU16B |
| 2016-01-01 | Not available in this setting | Rate data unavailable | RVU16A |
| 2015-10-01 | Not available in this setting | Rate data unavailable | RVU15D |
| 2015-07-01 | Not available in this setting | Rate data unavailable | RVU15C |
| 2015-04-01 | Not available in this setting | Rate data unavailable | RVU15B |
| 2015-01-01 | Not available in this setting | Rate data unavailable | RVU15A |
| 2014-10-01 | Not available in this setting | Rate data unavailable | RVU14D |
| 2014-07-01 | Not available in this setting | Rate data unavailable | RVU14C |
| 2014-04-01 | Not available in this setting | Rate data unavailable | RVU14B |
| 2014-01-01 | Not available in this setting | Rate data unavailable | RVU14A |
| 2013-10-01 | Not available in this setting | Rate data unavailable | RVU13D |
| 2013-07-01 | Not available in this setting | Rate data unavailable | RVU13C |
| 2013-04-01 | Not available in this setting | Rate data unavailable | RVU13B |
| 2013-01-01 | Not available in this setting | Rate data unavailable | RVU13AR |
Where the Napa, CA rate applies
Napa, CA is a Medicare payment area, not a city. Our Census mapping connects it to 11 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.
- Napa
- American Canyon
- Angwin
- Calistoga
- Deer Park
- Moskowite Corner
- Oakville
- Rutherford
35506 billing questions
How do I distinguish 35506 from a carotid-to-carotid bypass code?
Use the documented bypass endpoints. 35506 is for a subclavian-to-carotid route; carotid-to-carotid procedures are represented by different codes, including 35509 for a contralateral carotid target.
What operative details support reporting 35506?
The operative report should establish the subclavian origin, carotid target, indication for bypass, and that the graft route was completed. The stated endpoints distinguish this service from other arterial bypass codes.
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 code represents major surgery.
How is 35506 handled when other procedures occur in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%. Bilateral reporting with modifier 50 is paid at 150%; an assistant may be paid, while co-surgeon payment requires supporting documentation.
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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