CPT code 35638: Aortic bypass, bilateral iliac targets2026 Medicare rate & RVUs

Medicare pays $1,581.20 for 35638 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 35638 covers

A vascular surgeon performs an open bypass from the aorta to both iliac arteries using a graft other than vein, commonly a synthetic conduit. The operation may be performed for aortoiliac occlusive disease when reconstruction is needed to restore blood flow to both lower extremities. The key distinction is that the graft runs from the aorta to bilateral iliac artery targets, rather than to the femoral arteries.

Select this code when the operative report supports the aortic origin, both iliac outflow targets, and use of a non-vein graft. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. Modifier 50 is inappropriate for this bilateral configuration. Assistant-at-surgery payment may be made; 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 35638 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

35638 rates by state

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

How the 35638 rate is calculated

Each of 35638’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 35638

35638 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 51

35638 compared with similar codes

How to choose

35637Aortoiliac bypassAorta to one iliac artery

This code identifies a bypass from the aorta to both iliac arteries. Distinguish the aortoiliac code by the documented target configuration rather than assuming bilateral iliac targets.

35646Aortic bypassTo both femoral arteries

Both codes describe aortic bypasses, but this code has iliac artery targets; 35646 has bilateral femoral artery targets.

35647Aortic bypassSingle femoral target

This code has bilateral iliac targets. 35647 is the aortofemoral alternative when the operative report identifies a femoral artery target.

Codes related to 35638

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