CPT code 35623: Arterial bypass, axillary to popliteal or tibial2026 Medicare rate & RVUs in Texas
Reports an extra-anatomic bypass using a non-vein graft from the axillary artery to a popliteal or tibial artery to restore lower-extremity blood flow.
CMS doesn’t publish an office rate for 35623 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 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 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 | $1,180.78 |
| Beaumont, TX | Unavailable | $1,168.19 |
| Brazoria, TX | Unavailable | $1,153.88 |
| Dallas, TX | Unavailable | $1,172.21 |
| Fort Worth, TX | Unavailable | $1,173.65 |
| Galveston, TX | Unavailable | $1,164.50 |
| Houston, TX | Unavailable | $1,282.55 |
| Rest of Texas | Unavailable | $1,167.90 |
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.
How the rate is built · 35623
RVUs × geographic indexes × conversion factor
Work25.27
25.27 RVUs× 1.000 GPCI
Practice expense4.08
4.08 RVUs× 1.000 GPCI
Malpractice6.45
6.45 RVUs× 1.000 GPCI
Adjusted RVUs
35.8000
Conversion factor
$33.4009
Medicare rate
$1,195.75
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 35623
35623 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 35623
Arterial bypass, axillary to popliteal or tibial
| 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 · 35623
Arterial bypass, axillary to popliteal or tibial
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
35623 without 50 · national facility
$1,195.75
Arterial bypass, axillary to popliteal or tibial
35623-50 · Bilateral: 150%
$1,793.63
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).
35623 compared with similar codes
Compare codes · National
5 codes, side by side
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.
35623 billing questions
How is this code distinguished from an axillary-femoral bypass?
This code describes a bypass ending at the popliteal or tibial artery. An axillary-femoral bypass has a femoral artery as its distal target.
Can this code be used when the bypass conduit is vein?
No. This code is for a conduit other than vein. The vein-graft counterpart for the same axillary-to-popliteal or tibial route is 35523.
What operative details support reporting this code?
Document the axillary inflow artery, popliteal or tibial outflow artery, side, conduit material, and completed bypass route.
How does the 90-day global period affect postoperative reporting?
The day-before preoperative visit and related postoperative care during the 90-day period are included in the global surgery payment.
How are multiple procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are paid at 50%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation.
How is bilateral performance reported under the CMS rule?
When the procedure is performed bilaterally, modifier 50 applies, and the bilateral procedure is paid 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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