No office rate
Choose 35522 when the graft runs from the axillary artery to the brachial artery. Choose 35512 when it runs from the subclavian artery to the brachial artery.
On this page
CMS RVU26D · Effective 2026-10-01
35522 Arterial bypass Medicare reimbursement rates
Open vein-graft bypass from the axillary artery to the brachial artery reroutes upper-extremity blood flow around an obstructed segment. Compare 35522 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 35522?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 35522 pays more and less
Vascular surgery
About 35522: Axillary-to-brachial vein bypass
Open vein-graft bypass from the axillary artery to the brachial artery reroutes upper-extremity blood flow around an obstructed segment.
A vascular surgeon creates a vein-graft route from the axillary artery to the brachial artery to restore blood flow to the arm when disease obstructs the native arterial pathway. The operation is generally performed in a hospital or other surgical facility for patients with upper-extremity ischemia from arterial occlusive disease. The documented inflow and outflow sites distinguish this operation from bypasses beginning at the subclavian artery or ending in the forearm.
Report the code for the axillary-to-brachial bypass, documenting the side, target vessels, conduit, indication, and operative work. A separately performed vein harvest may be reported with 35500 when applicable. The day-before preoperative visit and 90 days of related postoperative care are included. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 identifies bilateral work and is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 35522
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU22.57 · 71%
- Practice expense (office) RVU3.54 · 11%
- Malpractice RVU5.76 · 18%
44
Medicare services in 2024 · #5431 by national volume
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.
35522 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
35516 describes a subclavian-to-axillary bypass; 35522 has the brachial artery as its outflow target.
No office rate
35518 connects axillary arteries across the body, while 35522 connects an axillary artery to a brachial artery.
No office rate
35523 is for a bypass involving the brachial and radial or ulnar arteries in the forearm, rather than an axillary-to-brachial route.
See how rates vary across the country
35522 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Compare 35522 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office Unavailable | Facility $966.21 |
| Alaska* | Office Unavailable | Facility $1362.72 |
| Arizona | Office Unavailable | Facility $1033.12 |
| Arkansas | Office Unavailable | Facility $954.51 |
| Atlanta | Office Unavailable | Facility $1107.31 |
| Austin | Office Unavailable | Facility $1050.92 |
| Bakersfield | Office Unavailable | Facility $1014.94 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $1130.78 |
| Beaumont | Office Unavailable | Facility $1040.19 |
| Brazoria | Office Unavailable | Facility $1027.13 |
| Chicago | Office Unavailable | Facility $1319.50 |
| Chico | Office Unavailable | Facility $999.38 |
| Colorado | Office Unavailable | Facility $1038.97 |
| Connecticut | Office Unavailable | Facility $1129.07 |
| Dallas | Office Unavailable | Facility $1043.48 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $1147.98 |
| Delaware | Office Unavailable | Facility $1047.41 |
| Detroit | Office Unavailable | Facility $1192.33 |
| East St. Louis | Office Unavailable | Facility $1250.11 |
| El Centro | Office Unavailable | Facility $1000.35 |
| Fort Lauderdale | Office Unavailable | Facility $1221.47 |
| Fort Worth | Office Unavailable | Facility $1044.80 |
| Fresno | Office Unavailable | Facility $999.38 |
| Galveston | Office Unavailable | Facility $1036.60 |
| Hanford-Corcoran | Office Unavailable | Facility $999.38 |
| Hawaii, Guam | Office Unavailable | Facility $999.69 |
| Houston | Office Unavailable | Facility $1142.03 |
| Idaho | Office Unavailable | Facility $953.64 |
| Indiana | Office Unavailable | Facility $956.97 |
| Iowa | Office Unavailable | Facility $938.43 |
| Kansas | Office Unavailable | Facility $957.71 |
| Kentucky | Office Unavailable | Facility $1035.01 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $1052.39 |
| Madera | Office Unavailable | Facility $999.38 |
| Manhattan | Office Unavailable | Facility $1244.63 |
| Merced | Office Unavailable | Facility $999.38 |
| Metropolitan Boston | Office Unavailable | Facility $1097.17 |
| Metropolitan Kansas City | Office Unavailable | Facility $1052.85 |
| Metropolitan Philadelphia | Office Unavailable | Facility $1120.04 |
| Metropolitan St. Louis | Office Unavailable | Facility $1059.20 |
| Miami | Office Unavailable | Facility $1363.50 |
| Minnesota | Office Unavailable | Facility $932.47 |
| Mississippi | Office Unavailable | Facility $997.84 |
| Modesto | Office Unavailable | Facility $999.38 |
| Montana** | Office Unavailable | Facility $1064.10 |
| Napa | Office Unavailable | Facility $1054.92 |
| Nebraska | Office Unavailable | Facility $935.72 |
| Nevada** | Office Unavailable | Facility $1032.48 |
| New Hampshire | Office Unavailable | Facility $1045.29 |
| New Mexico | Office Unavailable | Facility $1093.34 |
| New Orleans | Office Unavailable | Facility $1083.68 |
| North Carolina | Office Unavailable | Facility $987.11 |
| North Dakota** | Office Unavailable | Facility $950.21 |
| Northern Nj | Office Unavailable | Facility $1143.98 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $1299.96 |
| Ohio | Office Unavailable | Facility $1055.74 |
| Oklahoma | Office Unavailable | Facility $1008.93 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $1034.58 |
| Portland | Office Unavailable | Facility $1040.42 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $1150.04 |
| Puerto Rico | Office Unavailable | Facility $1062.90 |
| Queens | Office Unavailable | Facility $1219.29 |
| Redding | Office Unavailable | Facility $999.38 |
| Rest Of California | Office Unavailable | Facility $999.38 |
| Rest Of Florida | Office Unavailable | Facility $1156.06 |
| Rest Of Georgia | Office Unavailable | Facility $1088.66 |
| Rest Of Illinois | Office Unavailable | Facility $1162.51 |
| Rest Of Louisiana | Office Unavailable | Facility $1042.81 |
| Rest Of Maine | Office Unavailable | Facility $982.30 |
| Rest Of Maryland | Office Unavailable | Facility $1057.67 |
| Rest Of Massachusetts | Office Unavailable | Facility $1043.76 |
| Rest Of Michigan | Office Unavailable | Facility $1079.02 |
| Rest Of Missouri | Office Unavailable | Facility $1043.17 |
| Rest Of New Jersey | Office Unavailable | Facility $1124.18 |
| Rest Of New York | Office Unavailable | Facility $1001.44 |
| Rest Of Oregon | Office Unavailable | Facility $1006.87 |
| Rest Of Pennsylvania | Office Unavailable | Facility $1044.21 |
| Rest Of Texas | Office Unavailable | Facility $1039.79 |
| Rest Of Washington | Office Unavailable | Facility $1034.57 |
| Rhode Island | Office Unavailable | Facility $1061.93 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $1061.13 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $1021.63 |
| Salinas | Office Unavailable | Facility $1017.39 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $1022.16 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $1080.50 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $1073.96 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $1110.40 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $1083.66 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $1004.47 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $1016.47 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $1015.95 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $1024.79 |
| Seattle (King Cnty) | Office Unavailable | Facility $1093.81 |
| South Carolina | Office Unavailable | Facility $1026.64 |
| South Dakota** | Office Unavailable | Facility $936.74 |
| Southern Maine | Office Unavailable | Facility $992.43 |
| Stockton | Office Unavailable | Facility $999.38 |
| Suburban Chicago | Office Unavailable | Facility $1221.48 |
| Tennessee | Office Unavailable | Facility $964.65 |
| Utah | Office Unavailable | Facility $1037.77 |
| Vallejo | Office Unavailable | Facility $1045.50 |
| Vermont | Office Unavailable | Facility $968.26 |
| Virgin Islands | Office Unavailable | Facility $1062.90 |
| Virginia | Office Unavailable | Facility $1005.91 |
| Visalia | Office Unavailable | Facility $999.38 |
| West Virginia | Office Unavailable | Facility $1131.92 |
| Wisconsin | Office Unavailable | Facility $926.39 |
| Wyoming** | Office Unavailable | Facility $1014.47 |
| Yuba City | Office Unavailable | Facility $999.38 |
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35522 billing questions
How is this different from 35512?
This code describes a bypass originating at the axillary artery and ending at the brachial artery. Code 35512 is for a subclavian-to-brachial bypass.
When would 35500 be reported with this bypass?
When a separate upper-extremity vein harvest for the bypass is performed and reportable, 35500 may be reported with the bypass.
What operative details support code selection?
Document the side, axillary inflow, brachial outflow, vein conduit, indication, and bypass performed. Those vessel endpoints distinguish this code from nearby bypass configurations.
How is bilateral work reported?
Report bilateral work with modifier 50; CMS payment for the bilateral procedure is 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
4,34135518,,Art byp grft axillary-axilry,A,,22.08,3.38,NA,3.38,,5.63,31.09,31.09,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,3423551F,,Intrmed rsk thromboembolism,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4,34335521,,Art byp grft axill-femoral,A,,23.53,3.95,NA,3.95,,6.02,33.50,33.50,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,34435522,,Art byp grft axill-brachial,A,,22.57,3.54,NA,3.54,,5.76,31.87,31.87,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,34535523,,Art byp grft brchl-ulnr-rdl,A,,23.53,3.98,NA,3.98,,6.02,33.53,33.53,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,34635525,,Art byp grft brachial-brchl,A,,21.15,3.42,NA,3.42,,5.40,29.97,29.97,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,34735526,,Art byp grft aor/carot/innom,A,,30.76,10.80,NA,10.80,,7.38,48.94,48.94,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00