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Billing code 35535: Renal artery bypassMedicare rate & RVUs

Report this surgical bypass when a vein graft carries blood from the hepatic artery to a renal artery to restore kidney perfusion.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $1,728.16 for 35535 nationally in a facility.

Medicare rate · 35535

Renal artery bypass

Swap in your local Medicare rate.

Work RVUs
37.18
Total RVUs
51.74
Global days
090

National rate · 2026

$1,728.16

Facility setting, before claim adjustments.

See every locality for 35535 → · 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 35535 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 35535 covers

This operation creates a new arterial route to a kidney using the hepatic artery as the inflow source and a vein graft as the conduit. A vascular surgeon typically performs it in a hospital operating room for renal artery disease that requires surgical restoration of blood flow. The operative report should identify the hepatic and renal artery connections and the vein used for the graft.

Select this code by the arteries joined, not merely by the fact that the kidney receives a bypass. An aortic or splenic artery inflow calls for a different bypass code. CMS assigns a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care. When eligible procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. A qualifying bilateral procedure reported with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons require supporting documentation. 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 35535 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

35535 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,569.12
Alaska*Unavailable$2,217.26
ArizonaUnavailable$1,677.16
ArkansasUnavailable$1,550.21
AtlantaUnavailable$1,798.49
AustinUnavailable$1,704.16
BakersfieldUnavailable$1,643.59
Baltimore/Surr. CntysUnavailable$1,835.68
BeaumontUnavailable$1,690.44
BrazoriaUnavailable$1,666.63

35535 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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
35535 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 35535 rate is calculated

Each of 35535’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 · 35535

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 37.18Practice expense 5.04Malpractice 9.52

51.7400 adjusted RVUs×$33.4009 conversion factor=$1,728.16

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 35535

35535 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 35535

Renal artery 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 · 35535

Renal artery 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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

35535 without 50 · national facility

$1,728.16

Renal artery bypass

35535-50 · Bilateral: 150%

$2,592.24

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

35535 compared with similar codes

Compare codes

35535 vs 35536 vs 35560 vs 35531: national Medicare rates

Swap in your local Medicare rate.

  • 35535
    Renal artery bypass · 37.18 wRVU
    —
  • 35536
    Arterial bypass · 32.89 wRVU
    —
  • 35560
    Renal bypass · 33.18 wRVU
    —
  • 35531
    Visceral bypass · 38.13 wRVU
    —

How to choose

35536Arterial bypass
Both involve a vein graft supplying a renal artery. Choose 35535 for hepatic artery inflow and 35536 for splenic artery inflow.
35560Renal bypass
Choose 35535 when the vein graft begins at the hepatic artery; choose 35560 when it begins at the aorta.
35531Visceral bypass
35531 describes a vein bypass from the aorta to a celiac or mesenteric artery. This code describes hepatic artery inflow to a renal artery.

Codes related to 35535

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

Codes related to 35535
CodeHow it relatesNational office range
Same family
35536Arterial bypassVein bypass to a renal artery using splenic rather than hepatic artery inflow.No office rate
35531Visceral bypassVein bypass from the aorta to a celiac or mesenteric artery, rather than a renal artery.No office rate
Used instead
35560Renal bypassAortorenal vein bypass when the graft originates at the aorta instead.No office rate

35535 billing questions

How is this different from an aortorenal bypass?

This graft starts at the hepatic artery. An aortorenal vein bypass starts at the aorta and is reported with 35560.

Does a splenic-to-renal artery bypass use this code?

No. A vein graft from the splenic artery to a renal artery is reported with 35536.

What should the operative report show?

It should identify the hepatic artery as the inflow, the renal artery as the outflow, and the vein graft connecting them.

How does CMS handle another procedure in the same session?

Under the standard multiple-procedure reduction, CMS pays the highest-valued eligible procedure in full and other eligible procedures at 50%.

Can an assistant or co-surgeon be paid for this bypass?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, while team surgery is not permitted.

What care is included in the global period?

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

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 35535PPRRVU2026_Oct_nonQPP.csv, line 4,351 (RVU26D)

Open CMS sourceHow we calculate rates

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