CPT code 35526: Arterial bypass, aortic inflow, vein conduit2026 Medicare rate & RVUs in California
Reports open bypass using a vein conduit from the aorta to a carotid, innominate, or subclavian artery to restore arterial flow.
CMS doesn’t publish an office rate for 35526 in California.
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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On this page 9 sections
What 35526 covers
A vascular surgeon creates an open bypass from the aorta to a carotid, innominate, or subclavian artery using a vein conduit. The operation reroutes blood around an obstructed or unusable arterial segment to improve flow to the head or upper extremity. It is performed in an operating room, generally in a hospital setting, for selected patients with disease affecting the proximal branches of the aorta.
Report the code when the operative record supports both the aortic inflow and the specified outflow vessel, and identifies vein as the conduit. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 bilateral procedures are paid at 150%. Assistant-at-surgery payment may be available; 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.
Where 35526 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | Unavailable | $1,592.41 |
| Chico, CA | Unavailable | $1,572.36 |
| El Centro, CA | Unavailable | $1,573.59 |
| Fresno, CA | Unavailable | $1,572.36 |
| Hanford, CA | Unavailable | $1,572.36 |
| Los Angeles, CA | Unavailable | $1,659.95 |
| Madera, CA | Unavailable | $1,572.36 |
| Marin County, CA | Unavailable | $1,746.79 |
| Merced, CA | Unavailable | $1,572.36 |
| Modesto, CA | Unavailable | $1,572.36 |
| Napa, CA | Unavailable | $1,692.80 |
| Oxnard, CA | Unavailable | $1,636.13 |
| Redding, CA | Unavailable | $1,572.36 |
| Rest of California | Unavailable | $1,572.36 |
| Riverside, CA | Unavailable | $1,651.53 |
| Sacramento, CA | Unavailable | $1,616.05 |
| Salinas, CA | Unavailable | $1,609.47 |
| San Benito County, CA | Unavailable | $1,792.72 |
| San Diego, CA | Unavailable | $1,623.27 |
| San Francisco, CA | Unavailable | $1,738.41 |
| San Luis Obispo, CA | Unavailable | $1,587.87 |
| Santa Clara County, CA | Unavailable | $1,758.46 |
| Santa Cruz, CA | Unavailable | $1,619.40 |
| Santa Maria, CA | Unavailable | $1,608.91 |
| Santa Rosa, CA | Unavailable | $1,633.33 |
| Stockton, CA | Unavailable | $1,572.36 |
| Vallejo, CA | Unavailable | $1,680.72 |
| Visalia, CA | Unavailable | $1,572.36 |
| Yuba City, CA | Unavailable | $1,572.36 |
How the 35526 rate is calculated
Each of 35526’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 · 35526
RVUs × geographic indexes × conversion factor
Work30.76
30.76 RVUs× 1.000 GPCI
Practice expense10.80
10.80 RVUs× 1.000 GPCI
Malpractice7.38
7.38 RVUs× 1.000 GPCI
Adjusted RVUs
48.9400
Conversion factor
$33.4009
Medicare rate
$1,634.64
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 35526
35526 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 35526
Arterial bypass, aortic inflow, vein conduit
| 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 · 35526
Arterial bypass, aortic inflow, vein conduit
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
35526 without 50 · national facility
$1,634.64
Arterial bypass, aortic inflow, vein conduit
35526-50 · Bilateral: 150%
$2,451.96
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).
35526 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 35626Arterial bypassAorta to arch branch
- Choose 35526 when the bypass uses vein; 35626 describes the corresponding aortic-to-branch bypass using a conduit other than vein.
- 35501Carotid bypassIpsilateral carotid-to-carotid
- 35501 describes a carotid-to-carotid vein bypass. Use 35526 when the bypass inflow is the aorta.
- 35506Arterial bypassSubclavian to carotid
- 35506 describes a subclavian-to-carotid vein bypass. 35526 has aortic inflow and a carotid, innominate, or subclavian outflow.
35526 billing questions
How is this different from a carotid-to-carotid bypass?
This procedure uses the aorta as the inflow source. A carotid-to-carotid bypass has a carotid artery as the inflow source and is reported with the code for that configuration.
Does 35526 identify a vein conduit?
Yes. The operative documentation should identify vein as the bypass conduit as well as the aortic inflow and the outflow vessel.
Is vein harvesting described by this code?
The code describes the bypass using vein, not the separate act of harvesting it. When a vein is harvested, review 35500 and document the harvest service and site.
How does the 90-day global affect postoperative reporting?
The global includes the day-before preoperative visit and 90 days of related postoperative care. Routine related follow-up during that period is included in the surgical service.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeons require 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. For a bilateral procedure reported with modifier 50, CMS pays at 150%.
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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