CPT code 35516: Arterial bypass, subclavian to axillary2026 Medicare rate & RVUs in Delaware

In Delaware, Medicare pays $1,092.07 for 35516 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 35516 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 35516 covers

A vascular surgeon uses a vein conduit to route blood from the subclavian artery to the axillary artery, bypassing a segment that cannot provide adequate flow. The operation may be considered for upper-extremity ischemia caused by obstructive arterial disease when this specific inflow and outflow route is selected. The operative report should identify both anastomotic sites and describe the bypass performed.

Report this code for the subclavian-to-axillary route, not simply because the operation involves the shoulder or arm. Documentation should support the indication, the arteries connected, and the conduit used; separately performed vein harvest may be reportable when supported. Medicare assigns a 90-day major-surgery global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in one session, the highest-valued is paid in full and others at 50%. For bilateral performance, modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires 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 Delaware compares for 35516

Across 109 of 109 payment localities, the facility rate for 35516 runs from $965.49 in Wisconsin to $1,422.79 in Miami, FL. Delaware pays $1,092.07. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

35516 rates by state

Office rate range in each state. Select a state to see its payment localities.

See 35516 in every payment locality

How the 35516 rate is calculated

Each of 35516’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.

Payment rules and modifiers for 35516

35516 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

Codes related to 35516

Related codes aren’t interchangeable: bill the code that matches the service performed.

How 35516 has changed in Delaware

Price 35516 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

• Arden
• Ardencroft
• Ardentown
• Bear
• Bellefonte
• Bethany Beach
• Bethel
• Blades

Browse all communities in Delaware

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

Open CMS sourceHow we calculate rates