CPT code 35623: Arterial bypass, axillary to popliteal or tibial2026 Medicare rate & RVUs

Medicare pays $1,195.75 for 35623 nationally in a facility.

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

What 35623 covers

A vascular surgeon creates a bypass from the axillary artery to a popliteal or tibial artery using a conduit other than vein, commonly a prosthetic graft. The route brings blood from the upper-body arterial circulation to a distal leg artery and may be selected when the usual inflow route is unsuitable. The operation is performed in a surgical setting for significant lower-extremity arterial disease, including cases requiring limb-salvage revascularization.

Report the code for the completed axillary-to-popliteal or axillary-to-tibial bypass, not for an axillary-to-femoral configuration. The operative report should identify the inflow and outflow arteries, graft material, route, and side. This major surgery has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons are paid only with 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 35623 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

35623 rates by state

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

How the 35623 rate is calculated

Each of 35623’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 35623

35623 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

35623 compared with similar codes

How to choose

35523Arterial bypassBrachial to ulnar or radial

Both describe the axillary-to-popliteal or tibial route. Choose 35523 when the bypass conduit is vein; this code covers a non-vein conduit.

35621Arterial bypassAxillary inflow to femoral

Both use an axillary inflow and a non-vein graft, but 35621 ends at the femoral artery rather than the popliteal or tibial artery.

35654Arterial bypassAxillary inflow, both femorals

This code ends at a popliteal or tibial artery; 35654 describes an axillary-to-femoral-femoral configuration.

35656Arterial bypassFemoral to popliteal, non-vein

Both describe non-vein lower-extremity bypasses, but 35656 runs from the femoral artery to the popliteal artery rather than from the axillary artery.

Codes related to 35623

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

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