CPT code 35650: Arterial bypass, axillary to axillary2026 Medicare rate & RVUs

Medicare pays $931.22 for 35650 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 35650 covers

An axillary-to-axillary bypass creates an extra-anatomic route between the right and left axillary arteries, typically using a prosthetic conduit tunneled beneath the skin across the chest. A vascular surgeon may perform it to reroute blood around an obstructed proximal inflow vessel, such as in subclavian artery disease, when circulation to an arm needs restoration. The operation is generally performed in a hospital operating room. The operative report should identify both arterial anastomoses, the conduit and tunnel, and the reason for the bypass.

Report 35650 when the bypass connects axillary artery to axillary artery using a conduit other than vein. Choose a neighboring bypass code by the documented inflow and outflow arteries, not simply the incision or disease location. The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures at 50%. When modifier 50 is appropriate for a bilateral service, CMS pays 150%; the two ends of this single crossover graft alone are not two separate bypasses. 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 35650 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

35650 rates by state

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

How the 35650 rate is calculated

Each of 35650’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 35650

35650 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

35650 compared with similar codes

How to choose

35621Arterial bypassAxillary inflow to femoral

Select 35621 when the bypass runs from the axillary artery to the femoral artery; 35650 connects the two axillary arteries.

35654Arterial bypassAxillary inflow, both femorals

35654 describes an axillary-to-femoral-to-femoral configuration. 35650 describes a crossover between the right and left axillary arteries.

35626Arterial bypassAorta to arch branch

35626 uses the aorta as inflow and routes blood to a subclavian, innominate, or carotid artery; 35650 uses axillary-to-axillary endpoints.

Codes related to 35650

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