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Billing code 35506: Arterial bypassMedicare rate & RVUs

Reports an open graft bypass from the subclavian artery to the carotid artery, typically to reroute blood flow around obstructive disease.

CMS RVU26DEffective Oct 1, 2026109 payment localities30 Medicare services in 2024

Medicare pays $1,159.01 for 35506 nationally in a facility.

Medicare rate · 35506

Arterial bypass

Work RVUs
24.7
Total RVUs
34.70
Global days
090

National rate · 2026

$1,159.01

Facility setting, before claim adjustments.

See every locality for 35506 →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.

On this page 10 sections
  1. Medicare rate
  2. What 35506 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 35506 covers

This open vascular operation creates a graft route between the subclavian and carotid arteries to bypass an obstructed segment and restore blood flow. Vascular surgeons most often perform it in a hospital operating room for proximal subclavian artery disease associated with arm ischemia or subclavian steal. The operative report should identify the bypass origin and target, the reason for rerouting flow, and the graft procedure performed.

Report 35506 when the completed bypass runs from the subclavian artery to the carotid artery; select a neighboring bypass code when the documented endpoints differ. The 90-day global period includes 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 the others 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 35506 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

35506 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,052.14
Alaska*Unavailable$1,484.89
ArizonaUnavailable$1,124.84
ArkansasUnavailable$1,039.41
AtlantaUnavailable$1,205.82
AustinUnavailable$1,143.78
BakersfieldUnavailable$1,104.11
Baltimore/Surr. CntysUnavailable$1,231.16
BeaumontUnavailable$1,132.95
BrazoriaUnavailable$1,118.13

35506 rates by state

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

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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
35506 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 35506 rate is calculated

Each of 35506’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 · 35506

RVUs × geographic indexes × conversion factor

Work24.70

24.70 RVUs× 1.000 GPCI

Practice expense3.69

3.69 RVUs× 1.000 GPCI

Malpractice6.31

6.31 RVUs× 1.000 GPCI

Adjusted RVUs

34.7000

Conversion factor

$33.4009

Medicare rate

$1,159.01

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

Payment rules and modifiers for 35506

35506 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 35506

Arterial bypass

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 · 35506

Arterial bypass

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

35506 without 50 · national facility

$1,159.01

Arterial bypass

35506-50 · Bilateral: 150%

$1,738.52

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

35506 compared with similar codes

Compare codes · National

4 codes, side by side

  • 35506

    Arterial bypass24.7 wRVU

    Not priced

  • 35509

    Carotid bypass27.39 wRVU

    Not priced

  • 35508

    Arterial bypass25.44 wRVU

    Not priced

  • 35511

    Artery bypass21.65 wRVU

    Not priced

How to choose

35509Carotid bypass
35506 describes a subclavian-to-carotid bypass. 35509 is for a bypass to the contralateral carotid target.
35508Arterial bypass
Use 35506 for a subclavian-to-carotid route; 35508 identifies a carotid-to-vertebral route.
35511Artery bypass
35506 connects the subclavian and carotid arteries. 35511 connects the subclavian arteries to each other.

Codes related to 35506

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

Codes related to 35506
CodeHow it relatesNational office range
Same family
35508Arterial bypassA related bypass code with a carotid-to-vertebral target route.No office rate
35509Carotid bypassA related bypass code for a contralateral carotid target.No office rate
35511Artery bypassA related bypass code connecting the subclavian arteries.No office rate
35515Arterial bypassA related bypass code connecting the subclavian and vertebral arteries.No office rate
35516Arterial bypassA related bypass code connecting the subclavian and axillary arteries.No office rate

35506 billing questions

How do I distinguish 35506 from a carotid-to-carotid bypass code?

Use the documented bypass endpoints. 35506 is for a subclavian-to-carotid route; carotid-to-carotid procedures are represented by different codes, including 35509 for a contralateral carotid target.

What operative details support reporting 35506?

The operative report should establish the subclavian origin, carotid target, indication for bypass, and that the graft route was completed. The stated endpoints distinguish this service from other arterial bypass codes.

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

The day-before preoperative visit and 90 days of related postoperative care are included in the global period. The code represents major surgery.

How is 35506 handled when other procedures occur 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%. Bilateral reporting with modifier 50 is paid at 150%; an assistant may be paid, while co-surgeon payment requires supporting documentation.

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 35506PPRRVU2026_Oct_nonQPP.csv, line 4,332 (RVU26D)

Open CMS sourceHow we calculate rates

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