CPT code 35606: Arterial bypass, carotid to subclavian2026 Medicare rate & RVUs in Illinois
Open carotid-subclavian bypass with a non-vein conduit reroutes blood flow when proximal subclavian obstruction limits arm or vertebral circulation.
CMS doesn’t publish an office rate for 35606 in Illinois.
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 35606 covers
A vascular surgeon creates a new route from the carotid artery to the subclavian artery using a non-vein conduit, commonly a prosthetic graft. The operation can restore flow with proximal subclavian occlusive disease causing arm ischemia or vertebral steal, or preserve circulation when the subclavian origin must be covered during aortic repair. It is generally performed in a hospital operating room.
Report this code for the completed carotid-to-subclavian bypass using a non-vein conduit; a vein conduit follows a different code. The operative report should identify the inflow and outflow arteries, conduit, laterality, and reason for revascularization. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant may be paid; 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 35606 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago, IL | Unavailable | $1,311.60 |
| East St. Louis, IL | Unavailable | $1,241.68 |
| Rest of Illinois | Unavailable | $1,156.75 |
| Suburban Chicago, IL | Unavailable | $1,217.54 |
How the 35606 rate is calculated
Each of 35606’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 · 35606
RVUs × geographic indexes × conversion factor
Work21.90
21.90 RVUs× 1.000 GPCI
Practice expense4.41
4.41 RVUs× 1.000 GPCI
Malpractice5.57
5.57 RVUs× 1.000 GPCI
Adjusted RVUs
31.8800
Conversion factor
$33.4009
Medicare rate
$1,064.82
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 35606
35606 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 35606
Arterial bypass, carotid to subclavian
| 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 · 35606
Arterial bypass, carotid to subclavian
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
35606 without 50 · national facility
$1,064.82
Arterial bypass, carotid to subclavian
35606-50 · Bilateral: 150%
$1,597.23
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).
35606 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 35506Arterial bypassSubclavian to carotid
- The arterial route is the same, but 35506 applies when a vein conduit is used; 35606 is for a non-vein conduit.
- 35612Arterial bypassSubclavian to subclavian
- 35612 connects the two subclavian arteries. Choose 35606 when the bypass runs from the carotid artery to the subclavian artery.
- 35616Arterial bypassSubclavian to axillary
- 35616 uses the subclavian artery as inflow and the axillary artery as outflow; 35606 uses carotid inflow and subclavian outflow.
- 35626Arterial bypassAorta to arch branch
- 35626 uses the aorta as inflow for a bypass to a supra-aortic artery. 35606 begins at the carotid artery and ends at the subclavian artery.
35606 billing questions
How does this code differ from 35506?
Both describe a carotid-to-subclavian bypass, but 35606 is for a non-vein conduit. Use 35506 when the bypass is performed with a vein conduit.
What should the operative report document?
Document the carotid inflow, subclavian outflow, conduit type, laterality, and indication. These details establish the route and distinguish a non-vein bypass from a vein bypass or a different arterial reconstruction.
How is bilateral reporting handled?
For bilateral procedures, report modifier 50; CMS pays the bilateral procedure at 150%. Document the work performed on both sides.
What happens when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedure or procedures are paid at 50%.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only with 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
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