CPT code 35621: Arterial bypass, axillary inflow to femoral2026 Medicare rate & RVUs in Texas
Reports a non-vein bypass from the axillary artery to a femoral artery, typically to restore leg blood flow when aortic reconstruction is unsuitable.
CMS doesn’t publish an office rate for 35621 in Texas.
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 35621 covers
A vascular surgeon creates an extra-anatomic route from the axillary artery to a femoral artery using a conduit other than vein, often a synthetic graft. The graft is tunneled beneath the skin and connected to the arteries to carry blood around diseased or obstructed aortoiliac segments. This operation is generally performed in a hospital operating room for patients who need lower-extremity revascularization but are not suited to direct aortic reconstruction.
Report the code when the documented bypass connects axillary inflow to a femoral target; distinguish it from grafts extending to more distal leg arteries or crossing to the opposite femoral artery. The operative report should identify the inflow and outflow vessels, conduit, laterality, and bypass configuration. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; 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 35621 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | $979.44 |
| Beaumont, TX | Unavailable | $966.14 |
| Brazoria, TX | Unavailable | $956.28 |
| Dallas, TX | Unavailable | $971.22 |
| Fort Worth, TX | Unavailable | $972.17 |
| Galveston, TX | Unavailable | $964.91 |
| Houston, TX | Unavailable | $1,060.45 |
| Rest of Texas | Unavailable | $966.73 |
How the 35621 rate is calculated
Each of 35621’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 · 35621
RVUs × geographic indexes × conversion factor
Work20.50
20.50 RVUs× 1.000 GPCI
Practice expense3.93
3.93 RVUs× 1.000 GPCI
Malpractice5.22
5.22 RVUs× 1.000 GPCI
Adjusted RVUs
29.6500
Conversion factor
$33.4009
Medicare rate
$990.34
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 35621
35621 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 35621
Arterial bypass, axillary inflow to femoral
| 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 · 35621
Arterial bypass, axillary inflow to femoral
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
35621 without 50 · national facility
$990.34
Arterial bypass, axillary inflow to femoral
35621-50 · Bilateral: 150%
$1,485.51
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).
35621 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 35654Arterial bypassAxillary inflow, both femorals
- 35621 connects axillary inflow to a femoral artery. Choose 35654 when the configuration continues across to the opposite femoral distribution.
- 35623Arterial bypassAxillary to popliteal or tibial
- Use 35621 when the distal anastomosis is femoral; 35623 describes an axillary bypass to a popliteal or tibial artery.
- 35661Femoral bypassFemoral-to-femoral, nonvein graft
- 35661 uses one femoral artery as inflow for a crossover graft to the other femoral artery. 35621 instead brings inflow from the axillary artery.
- 35646Aortic bypassTo both femoral arteries
- 35646 describes an aortic-to-bilateral-femoral reconstruction. 35621 uses axillary inflow for an extra-anatomic route to a femoral artery.
35621 billing questions
When is 35621 preferred over 35654?
Use 35621 for a bypass from the axillary artery to a femoral artery. Code 35654 describes an axillary-to-femoral-femoral configuration that also supplies the opposite femoral distribution.
How does 35621 differ from an axillary-to-popliteal bypass?
The distal target determines the distinction: 35621 ends at a femoral artery, while 35623 reaches a popliteal or tibial artery.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral performance reported?
When the bypass is performed bilaterally, modifier 50 is associated with payment at 150%.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What operative details support reporting 35621?
Document the axillary inflow, femoral outflow, conduit type, laterality, and bypass configuration so the route can be distinguished from other extra-anatomic grafts.
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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