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Billing code 35606: Arterial bypassMedicare rate & RVUs

Open carotid-subclavian bypass with a non-vein conduit reroutes blood flow when proximal subclavian obstruction limits arm or vertebral circulation.

CMS RVU26DEffective Oct 1, 2026109 payment localities670 Medicare services in 2024

Medicare pays $1,064.82 for 35606 nationally in a facility.

Medicare rate · 35606

Arterial bypass

Swap in your local Medicare rate.

Work RVUs
21.9
Total RVUs
31.88
Global days
090

National rate · 2026

$1,064.82

Facility setting, before claim adjustments.

See every locality for 35606 → · 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 35606 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 35606 covers

A vascular surgeon creates a new route from the carotid artery to the subclavian artery using a non-vein conduit, commonly a prosthetic graft. The operation can restore flow with proximal subclavian occlusive disease causing arm ischemia or vertebral steal, or preserve circulation when the subclavian origin must be covered during aortic repair. It is generally performed in a hospital operating room.

Report this code for the completed carotid-to-subclavian bypass using a non-vein conduit; a vein conduit follows a different code. The operative report should identify the inflow and outflow arteries, conduit, laterality, and reason for revascularization. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant may be paid; co-surgeons require 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 35606 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

35606 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$965.67
Alaska*Unavailable$1,356.60
ArizonaUnavailable$1,033.46
ArkansasUnavailable$953.82
AtlantaUnavailable$1,106.77
AustinUnavailable$1,053.62
BakersfieldUnavailable$1,020.12
Baltimore/Surr. CntysUnavailable$1,131.37
BeaumontUnavailable$1,038.35
BrazoriaUnavailable$1,028.42

35606 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
35606 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 35606 rate is calculated

Each of 35606’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 · 35606

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 21.90Practice expense 4.41Malpractice 5.57

31.8800 adjusted RVUs×$33.4009 conversion factor=$1,064.82

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

Payment rules and modifiers for 35606

35606 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 35606

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 · 35606

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.

  • 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

35606 without 50 · national facility

$1,064.82

Arterial bypass

35606-50 · Bilateral: 150%

$1,597.23

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

35606 compared with similar codes

Compare codes

35606 vs 35506 vs 35612 vs 35616 vs 35626: national Medicare rates

Swap in your local Medicare rate.

  • 35606
    Arterial bypass · 21.9 wRVU
    —
  • 35506
    Arterial bypass · 24.7 wRVU
    —
  • 35612
    Arterial bypass · 19.84 wRVU
    —
  • 35616
    Arterial bypass · 21.27 wRVU
    —
  • 35626
    Arterial bypass · 28.41 wRVU
    —

How to choose

35506Arterial bypass
The arterial route is the same, but 35506 applies when a vein conduit is used; 35606 is for a non-vein conduit.
35612Arterial bypass
35612 connects the two subclavian arteries. Choose 35606 when the bypass runs from the carotid artery to the subclavian artery.
35616Arterial bypass
35616 uses the subclavian artery as inflow and the axillary artery as outflow; 35606 uses carotid inflow and subclavian outflow.
35626Arterial bypass
35626 uses the aorta as inflow for a bypass to a supra-aortic artery. 35606 begins at the carotid artery and ends at the subclavian artery.

Codes related to 35606

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

Codes related to 35606
CodeHow it relatesNational office range
Used instead
35506Arterial bypassSame carotid-to-subclavian route performed with a vein conduit.No office rate
35612Arterial bypassUses a subclavian-to-subclavian route rather than carotid inflow.No office rate
35616Arterial bypassRoutes flow from the subclavian artery to the axillary artery.No office rate
35626Arterial bypassUses aortic inflow for a bypass to a supra-aortic artery.No office rate

35606 billing questions

How does this code differ from 35506?

Both describe a carotid-to-subclavian bypass, but 35606 is for a non-vein conduit. Use 35506 when the bypass is performed with a vein conduit.

What should the operative report document?

Document the carotid inflow, subclavian outflow, conduit type, laterality, and indication. These details establish the route and distinguish a non-vein bypass from a vein bypass or a different arterial reconstruction.

How is bilateral reporting handled?

For bilateral procedures, report modifier 50; CMS pays the bilateral procedure at 150%. Document the work performed on both sides.

What happens when another procedure is performed in the same session?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedure or procedures are paid at 50%.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeons are paid only with 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 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 35606PPRRVU2026_Oct_nonQPP.csv, line 4,373 (RVU26D)

Open CMS sourceHow we calculate rates

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