CPT code 35506: Arterial bypass, subclavian to carotid2026 Medicare rate & RVUs in Pennsylvania
Reports an open graft bypass from the subclavian artery to the carotid artery, typically to reroute blood flow around obstructive disease.
CMS doesn’t publish an office rate for 35506 in Pennsylvania.
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 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.
Where 35506 pays more and less in Pennsylvania
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Philadelphia, PA | Unavailable | $1,219.59 |
| Rest of Pennsylvania | Unavailable | $1,137.31 |
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.
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).
35506 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 35509Carotid bypassContralateral carotid, vein graft
- 35506 describes a subclavian-to-carotid bypass. 35509 is for a bypass to the contralateral carotid target.
- 35508Arterial bypassCarotid to vertebral
- Use 35506 for a subclavian-to-carotid route; 35508 identifies a carotid-to-vertebral route.
- 35511Artery bypassSubclavian to subclavian, vein graft
- 35506 connects the subclavian and carotid arteries. 35511 connects the subclavian arteries to each other.
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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