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CPT code 35634: Arterial bypass, iliac-to-renal, non-vein graft2026 Medicare rate & RVUs

Open bypass from an iliac artery to a renal artery using a non-vein conduit is reported for selected renal revascularization procedures.

CMS RVU26DEffective Oct 1, 2026109 payment localities24 Medicare services in 2024

Medicare pays $1,605.92 for 35634 nationally in a facility.

Medicare rate · 35634

Arterial bypass, iliac-to-renal, non-vein graft

Office or facility?

Work RVUs
34.45
Total RVUs
48.08
Global days
090

National rate · 2026

$1,605.92

Facility setting, before claim adjustments.

See every locality for 35634 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 35634 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 35634 covers

A vascular surgeon creates a grafted route from an iliac artery to a renal artery to improve blood flow to the kidney. This open operation may be performed for selected renal artery disease, such as stenosis associated with impaired renal perfusion or renovascular hypertension. Code 35634 identifies the iliorenal route using a conduit other than vein, such as a prosthetic graft. It is generally performed in a hospital operating room.

Select the code from the documented inflow artery, renal artery target, and conduit. The operative report should identify the bypass route and graft material; a vein conduit is represented by a different code. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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%. Assistant-at-surgery payment may be made; 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 35634 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

35634 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,458.08
AlaskaUnavailable$2,059.59
ArizonaUnavailable$1,558.55
ArkansasUnavailable$1,440.50
Atlanta, GAUnavailable$1,671.09
Austin, TXUnavailable$1,584.01
Bakersfield, CAUnavailable$1,528.18
Baltimore area, MDUnavailable$1,705.82
Beaumont, TXUnavailable$1,570.53
Brazoria, TXUnavailable$1,548.93

35634 rates by state

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

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Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
35634 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 35634 rate is calculated

Each of 35634’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 · 35634

RVUs × geographic indexes × conversion factor

Office or facility?

Work34.45

34.45 RVUs× 1.000 GPCI

Practice expense4.82

4.82 RVUs× 1.000 GPCI

Malpractice8.81

8.81 RVUs× 1.000 GPCI

Adjusted RVUs

48.0800

Conversion factor

$33.4009

Medicare rate

$1,605.92

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 35634

35634 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 35634

Arterial bypass, iliac-to-renal, non-vein graft

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.84/0.07Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 35634

Arterial bypass, iliac-to-renal, non-vein graft

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

35634 without 50 · national facility

$1,605.92

Arterial bypass, iliac-to-renal, non-vein graft

35634-50 · Bilateral: 150%

$2,408.88

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).

When to use modifier 50

35634 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 35634

    Arterial bypass, iliac-to-renal, non-vein graft34.45 wRVU

    Not priced

  • 35535

    Renal artery bypass, hepatic artery inflow, vein graft37.18 wRVU

    Not priced

  • 35631

    Aortic bypass, celiac, mesenteric, and renal targets35.13 wRVU

    Not priced

  • 35633

    Arterial bypass, iliac to mesenteric artery38.13 wRVU

    Not priced

How to choose

35535Renal artery bypassHepatic artery inflow, vein graft
Both describe an ilio-renal bypass route. Choose 35535 when the conduit is vein; 35634 is for a conduit other than vein.
35631Aortic bypassCeliac, mesenteric, and renal targets
35631 describes an aortic-origin bypass to celiac, mesenteric, or renal arteries. Use 35634 for an iliac-origin bypass specifically to a renal artery.
35633Arterial bypassIliac to mesenteric artery
35633 is an iliac-to-mesenteric bypass. The iliac origin is shared, but 35634 targets a renal artery.

Codes related to 35634

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

Codes related to 35634
CodeHow it relatesNational office range
Used instead
35535Renal artery bypass, hepatic artery inflow, vein graftIlio-renal bypass using a vein conduit rather than a non-vein graft.No office rate
Same family
35631Aortic bypass, celiac, mesenteric, and renal targetsRelated bypass family; uses an aortic origin and targets visceral or renal arteries.No office rate
35632Arterial bypass, iliac inflow to celiac arteryIlio-celiac bypass; shares the iliac origin but has a different arterial target.No office rate
35633Arterial bypass, iliac to mesenteric arteryIlio-mesenteric bypass; shares the iliac origin but targets a mesenteric artery.No office rate
35636Arterial bypass, splenic-to-renal, non-vein graftSplenorenal bypass, with a different inflow artery and bypass route.No office rate

35634 billing questions

When should 35634 be selected instead of the vein-graft code?

Use 35634 for an ilio-renal bypass made with a conduit other than vein. The corresponding vein-graft route is reported with 35535.

What documentation supports 35634?

The operative report should establish the iliac inflow, renal artery target, and use of a non-vein conduit. It should also describe the bypass performed.

How is a bilateral ilio-renal bypass reported?

When the procedure is bilateral, report modifier 50 as appropriate; CMS pays the bilateral procedure at 150%.

Can an assistant surgeon or co-surgeon be reported?

Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation, and CMS does not permit team-surgery payment for this service.

How does the 90-day global period affect postoperative billing?

The global period includes the day-before preoperative visit and 90 days of related postoperative care.

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 other procedures are paid at 50%.

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
RVUs for 35634PPRRVU2026_Oct_nonQPP.csv, line 4,382 (RVU26D)

Open CMS sourceHow we calculate rates

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