CPT code 35522: Arterial bypass, axillary to brachial2026 Medicare rate & RVUs in Oregon
Open vein-graft bypass from the axillary artery to the brachial artery reroutes upper-extremity blood flow around an obstructed segment.
CMS doesn’t publish an office rate for 35522 in Oregon.
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 35522 covers
A vascular surgeon creates a vein-graft route from the axillary artery to the brachial artery to restore blood flow to the arm when disease obstructs the native arterial pathway. The operation is generally performed in a hospital or other surgical facility for patients with upper-extremity ischemia from arterial occlusive disease. The documented inflow and outflow sites distinguish this operation from bypasses beginning at the subclavian artery or ending in the forearm.
Report the code for the axillary-to-brachial bypass, documenting the side, target vessels, conduit, indication, and operative work. A separately performed vein harvest may be reported with 35500 when applicable. The day-before preoperative visit and 90 days of related postoperative care are included. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 identifies bilateral work and 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.
Where 35522 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland, OR | Unavailable | $1,040.42 |
| Rest of Oregon | Unavailable | $1,006.87 |
How the 35522 rate is calculated
Each of 35522’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 · 35522
RVUs × geographic indexes × conversion factor
Work22.57
22.57 RVUs× 1.000 GPCI
Practice expense3.54
3.54 RVUs× 1.000 GPCI
Malpractice5.76
5.76 RVUs× 1.000 GPCI
Adjusted RVUs
31.8700
Conversion factor
$33.4009
Medicare rate
$1,064.49
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 35522
35522 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 35522
Arterial bypass, axillary to brachial
| 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 · 35522
Arterial bypass, axillary to brachial
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
35522 without 50 · national facility
$1,064.49
Arterial bypass, axillary to brachial
35522-50 · Bilateral: 150%
$1,596.74
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).
35522 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 35512Arterial bypassSubclavian-to-brachial route
- Choose 35522 when the graft runs from the axillary artery to the brachial artery. Choose 35512 when it runs from the subclavian artery to the brachial artery.
- 35516Arterial bypassSubclavian to axillary
- 35516 describes a subclavian-to-axillary bypass; 35522 has the brachial artery as its outflow target.
- 35518Arterial bypassAxillary to axillary
- 35518 connects axillary arteries across the body, while 35522 connects an axillary artery to a brachial artery.
- 35523Arterial bypassBrachial to ulnar or radial
- 35523 is for a bypass involving the brachial and radial or ulnar arteries in the forearm, rather than an axillary-to-brachial route.
35522 billing questions
How is this different from 35512?
This code describes a bypass originating at the axillary artery and ending at the brachial artery. Code 35512 is for a subclavian-to-brachial bypass.
When would 35500 be reported with this bypass?
When a separate upper-extremity vein harvest for the bypass is performed and reportable, 35500 may be reported with the bypass.
What operative details support code selection?
Document the side, axillary inflow, brachial outflow, vein conduit, indication, and bypass performed. Those vessel endpoints distinguish this code from nearby bypass configurations.
How is bilateral work reported?
Report bilateral work with modifier 50; CMS payment for the bilateral procedure is 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 paid?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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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