No office rate
35691 directly transposes the vertebral artery to the carotid artery. 35642 describes a carotid-vertebral bypass rather than direct relocation.
On this page
CMS RVU26D · Effective 2026-10-01
35691 in Austin
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$853.25
Base rate per service
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.
Vascular surgery
About 35691: Vertebral-to-carotid artery transposition
Reports surgical relocation of a vertebral artery to the carotid artery to restore blood flow in selected patients with vertebral artery disease.
A vascular surgeon mobilizes the vertebral artery and reconnects it directly to the carotid artery, routing blood around a diseased proximal segment without creating a separate bypass conduit. The operation is performed in the neck, typically in a hospital operating room, for selected patients with symptomatic vertebral artery occlusive disease affecting blood flow to the posterior circulation.
Report this code when the operative work is a direct vertebral-to-carotid transposition, rather than a bypass between those vessels. The operative report should identify the vessels and side, describe the transposition and anastomosis, and support the clinical indication. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For bilateral procedures, modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. An assistant at surgery may be paid; co-surgeons are paid only with supporting documentation, and team surgery is not permitted.
CMS billing rules for 35691
- 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 RVU17.95 · 69%
- Practice expense (office) RVU3.31 · 13%
- Malpractice RVU4.58 · 18%
48
Medicare services in 2024 · #5376 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.
35691 compared with similar codes
Office rates for Austin, from the same CMS release.
No office rate
35691 connects the vertebral artery directly to the carotid artery; 35645 describes a bypass from the subclavian artery to the vertebral artery.
No office rate
35691 transposes the vertebral artery to the carotid artery. 35694 concerns transposition of the subclavian artery to the carotid artery.
No office rate
35691 is a vertebral-to-carotid transposition; 35695 transposes the carotid artery to the subclavian artery.
The same code, a different location
How does Austin compare?
35691 across payment areas
Same release and payment basis · bars start at $0
Austin · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in Texas appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Rest Of Texas
Texas · 35691
Office
Unavailable
Facility
$842.60
No comparable office rate is available.
Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)
California · 35691
Office
Unavailable
Facility
$856.49
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 35691
Office
Unavailable
Facility
$932.42
No comparable office rate is available.
Miami
Florida · 35691
Office
Unavailable
Facility
$1101.51
No comparable office rate is available.
Chicago
Illinois · 35691
Office
Unavailable
Facility
$1065.93
No comparable office rate is available.
Manhattan
New York · 35691
Office
Unavailable
Facility
$1009.00
No comparable office rate is available.
Alaska*
Alaska · 35691
Office
Unavailable
Facility
$1101.35
No comparable office rate is available.
Alabama
Alabama · 35691
Office
Unavailable
Facility
$782.87
No comparable office rate is available.
Arkansas
Arkansas · 35691
Office
Unavailable
Facility
$773.30
No comparable office rate is available.
Arizona
Arizona · 35691
Office
Unavailable
Facility
$837.62
No comparable office rate is available.
Bakersfield
California · 35691
Office
Unavailable
Facility
$825.27
No comparable office rate is available.
Chico
California · 35691
Office
Unavailable
Facility
$812.90
No comparable office rate is available.
El Centro
California · 35691
Office
Unavailable
Facility
$813.67
No comparable office rate is available.
Fresno
California · 35691
Office
Unavailable
Facility
$812.90
No comparable office rate is available.
Hanford-Corcoran
California · 35691
Office
Unavailable
Facility
$812.90
No comparable office rate is available.
Madera
California · 35691
Office
Unavailable
Facility
$812.90
No comparable office rate is available.
Merced
California · 35691
Office
Unavailable
Facility
$812.90
No comparable office rate is available.
Modesto
California · 35691
Office
Unavailable
Facility
$812.90
No comparable office rate is available.
Napa
California · 35691
Office
Unavailable
Facility
$860.74
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 35691
Office
Unavailable
Facility
$842.32
No comparable office rate is available.
Redding
California · 35691
Office
Unavailable
Facility
$812.90
No comparable office rate is available.
Rest Of California
California · 35691
Office
Unavailable
Facility
$812.90
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 35691
Office
Unavailable
Facility
$862.00
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 35691
Office
Unavailable
Facility
$831.70
No comparable office rate is available.
Salinas
California · 35691
Office
Unavailable
Facility
$828.26
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 35691
Office
Unavailable
Facility
$832.67
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 35691
Office
Unavailable
Facility
$882.60
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 35691
Office
Unavailable
Facility
$877.40
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 35691
Office
Unavailable
Facility
$906.91
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 35691
Office
Unavailable
Facility
$885.65
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 35691
Office
Unavailable
Facility
$817.66
No comparable office rate is available.
Santa Cruz-Watsonville
California · 35691
Office
Unavailable
Facility
$828.46
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 35691
Office
Unavailable
Facility
$827.24
No comparable office rate is available.
Santa Rosa-Petaluma
California · 35691
Office
Unavailable
Facility
$835.29
No comparable office rate is available.
Stockton
California · 35691
Office
Unavailable
Facility
$812.90
No comparable office rate is available.
Vallejo
California · 35691
Office
Unavailable
Facility
$853.25
No comparable office rate is available.
Visalia
California · 35691
Office
Unavailable
Facility
$812.90
No comparable office rate is available.
Yuba City
California · 35691
Office
Unavailable
Facility
$812.90
No comparable office rate is available.
Colorado
Colorado · 35691
Office
Unavailable
Facility
$843.85
No comparable office rate is available.
Connecticut
Connecticut · 35691
Office
Unavailable
Facility
$915.71
No comparable office rate is available.
Delaware
Delaware · 35691
Office
Unavailable
Facility
$849.30
No comparable office rate is available.
Fort Lauderdale
Florida · 35691
Office
Unavailable
Facility
$988.12
No comparable office rate is available.
Rest Of Florida
Florida · 35691
Office
Unavailable
Facility
$935.16
No comparable office rate is available.
Atlanta
Georgia · 35691
Office
Unavailable
Facility
$897.40
No comparable office rate is available.
Rest Of Georgia
Georgia · 35691
Office
Unavailable
Facility
$880.51
No comparable office rate is available.
Hawaii, Guam
Hawaii · 35691
Office
Unavailable
Facility
$813.82
No comparable office rate is available.
Iowa
Iowa · 35691
Office
Unavailable
Facility
$761.44
No comparable office rate is available.
Idaho
Idaho · 35691
Office
Unavailable
Facility
$773.62
No comparable office rate is available.
East St. Louis
Illinois · 35691
Office
Unavailable
Facility
$1009.35
No comparable office rate is available.
Rest Of Illinois
Illinois · 35691
Office
Unavailable
Facility
$939.59
No comparable office rate is available.
Suburban Chicago
Illinois · 35691
Office
Unavailable
Facility
$988.36
No comparable office rate is available.
Indiana
Indiana · 35691
Office
Unavailable
Facility
$776.38
No comparable office rate is available.
Kansas
Kansas · 35691
Office
Unavailable
Facility
$776.59
No comparable office rate is available.
Kentucky
Kentucky · 35691
Office
Unavailable
Facility
$837.80
No comparable office rate is available.
New Orleans
Louisiana · 35691
Office
Unavailable
Facility
$877.36
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 35691
Office
Unavailable
Facility
$843.94
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 35691
Office
Unavailable
Facility
$892.28
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 35691
Office
Unavailable
Facility
$847.48
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 35691
Office
Unavailable
Facility
$917.00
No comparable office rate is available.
Rest Of Maryland
Maryland · 35691
Office
Unavailable
Facility
$857.86
No comparable office rate is available.
Rest Of Maine
Maine · 35691
Office
Unavailable
Facility
$796.41
No comparable office rate is available.
Southern Maine
Maine · 35691
Office
Unavailable
Facility
$805.64
No comparable office rate is available.
Detroit
Michigan · 35691
Office
Unavailable
Facility
$964.15
No comparable office rate is available.
Rest Of Michigan
Michigan · 35691
Office
Unavailable
Facility
$873.19
No comparable office rate is available.
Minnesota
Minnesota · 35691
Office
Unavailable
Facility
$758.59
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 35691
Office
Unavailable
Facility
$852.82
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 35691
Office
Unavailable
Facility
$858.08
No comparable office rate is available.
Rest Of Missouri
Missouri · 35691
Office
Unavailable
Facility
$843.85
No comparable office rate is available.
Mississippi
Mississippi · 35691
Office
Unavailable
Facility
$807.79
No comparable office rate is available.
Montana**
Montana · 35691
Office
Unavailable
Facility
$862.77
No comparable office rate is available.
North Carolina
North Carolina · 35691
Office
Unavailable
Facility
$800.45
No comparable office rate is available.
North Dakota**
North Dakota · 35691
Office
Unavailable
Facility
$772.21
No comparable office rate is available.
Nebraska
Nebraska · 35691
Office
Unavailable
Facility
$759.42
No comparable office rate is available.
New Hampshire
New Hampshire · 35691
Office
Unavailable
Facility
$848.49
No comparable office rate is available.
Northern Nj
New Jersey · 35691
Office
Unavailable
Facility
$928.94
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 35691
Office
Unavailable
Facility
$912.07
No comparable office rate is available.
New Mexico
New Mexico · 35691
Office
Unavailable
Facility
$884.65
No comparable office rate is available.
Nevada**
Nevada · 35691
Office
Unavailable
Facility
$837.64
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 35691
Office
Unavailable
Facility
$1053.45
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 35691
Office
Unavailable
Facility
$932.69
No comparable office rate is available.
Queens
New York · 35691
Office
Unavailable
Facility
$989.19
No comparable office rate is available.
Rest Of New York
New York · 35691
Office
Unavailable
Facility
$812.12
No comparable office rate is available.
Ohio
Ohio · 35691
Office
Unavailable
Facility
$854.68
No comparable office rate is available.
Oklahoma
Oklahoma · 35691
Office
Unavailable
Facility
$817.14
No comparable office rate is available.
Portland
Oregon · 35691
Office
Unavailable
Facility
$845.78
No comparable office rate is available.
Rest Of Oregon
Oregon · 35691
Office
Unavailable
Facility
$817.20
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 35691
Office
Unavailable
Facility
$907.93
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 35691
Office
Unavailable
Facility
$845.60
No comparable office rate is available.
Puerto Rico
Puerto Rico · 35691
Office
Unavailable
Facility
$862.00
No comparable office rate is available.
Rhode Island
Rhode Island · 35691
Office
Unavailable
Facility
$861.60
No comparable office rate is available.
South Carolina
South Carolina · 35691
Office
Unavailable
Facility
$831.73
No comparable office rate is available.
South Dakota**
South Dakota · 35691
Office
Unavailable
Facility
$761.50
No comparable office rate is available.
Tennessee
Tennessee · 35691
Office
Unavailable
Facility
$782.19
No comparable office rate is available.
Utah
Utah · 35691
Office
Unavailable
Facility
$840.84
No comparable office rate is available.
Virginia
Virginia · 35691
Office
Unavailable
Facility
$816.22
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 35691
Office
Unavailable
Facility
$862.00
No comparable office rate is available.
Vermont
Vermont · 35691
Office
Unavailable
Facility
$786.40
No comparable office rate is available.
Rest Of Washington
Washington · 35691
Office
Unavailable
Facility
$840.17
No comparable office rate is available.
Seattle (King Cnty)
Washington · 35691
Office
Unavailable
Facility
$890.16
No comparable office rate is available.
Wisconsin
Wisconsin · 35691
Office
Unavailable
Facility
$752.58
No comparable office rate is available.
West Virginia
West Virginia · 35691
Office
Unavailable
Facility
$914.53
No comparable office rate is available.
Wyoming**
Wyoming · 35691
Office
Unavailable
Facility
$823.31
No comparable office rate is available.
See how rates vary across the country
35691 · 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 |
Where does this rate apply?
Austin is a Medicare payment area. Our Census mapping connects it to 31 cities and communities in Texas, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
- 35691 in Austin
Multiple payment areas
- 35691 in Barton Creek
- 35691 in Bee Cave
- 35691 in Briarcliff
- 35691 in Cedar Park
Multiple payment areas
- 35691 in Creedmoor
Multiple payment areas
- 35691 in Elgin
Multiple payment areas
- 35691 in Garfield
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 35691 in Austin. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$938.58
$853.25 × 110% = $938.58
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 35691 in Austin.
PPRRVU2026_Oct_nonQPP.csv
4,403
- Code
- 35691
- Physician work
- 17.95
- Practice expense
- 3.31
- Malpractice
- 4.58
GPCI2026.csv
96
- Locality
- Austin
- Physician work
- 1.002
- Practice expense
- 1.058
- Malpractice
- 0.886
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 17.95 | × 1.002 | 17.9859 |
| Practice expense | 3.31 | × 1.058 | 3.5020 |
| Malpractice | 4.58 | × 0.886 | 4.0579 |
| Total RVUs | 25.5458 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Austin$853.25
Open 35691 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 17.95 | 1.002 |
| Practice expense | 3.31 | 1.058 |
| Malpractice | 4.58 | 0.886 |
(17.95 × 1.002 + 3.31 × 1.058 + 4.58 × 0.886) × $33.4009 = $853.25
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
35691 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $853.25 | RVU26D |
| 2026-07-01 | Not available in this setting | $853.25 | RVU26C |
| 2026-04-01 | Not available in this setting | $853.25 | RVU26B |
| 2026-01-01 | Not available in this setting | $853.25 | RVU26A |
| 2025-10-01 | Not available in this setting | $894.92 | RVU25D |
| 2025-07-01 | Not available in this setting | $894.92 | RVU25C |
| 2025-04-01 | Not available in this setting | $894.92 | RVU25B |
| 2025-01-01 | Not available in this setting | $894.92 | RVU25A |
35691 billing questions
When is 35691 appropriate instead of a carotid-vertebral bypass?
Use 35691 when the vertebral artery is directly transposed and reconnected to the carotid artery. A separate bypass between the vessels is reported with the applicable bypass code, such as 35642.
Does 35691 describe a bypass graft?
No. It describes direct relocation and reconnection of the vertebral artery; it is not the code for constructing a separate graft bypass.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is a bilateral procedure handled?
CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only when supporting documentation is provided.
What operative details support code selection?
Document the vertebral and carotid vessels, the side, the direct transposition and reconnection, and the clinical reason for revascularization.
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.
4,40035683,,Composite byp grft 3/> segmt,A,,8.28,0.66,NA,0.66,,2.11,11.05,11.05,0,ZZZ,0.00,0.00,0.00,0,0,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,40135685,,Bypass graft patency/patch,A,,3.94,0.39,NA,0.39,,1.02,5.35,5.35,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,40235686,,Bypass graft/av fist patency,A,,3.26,0.26,NA,0.26,,0.83,4.35,4.35,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,40335691,,Art trnsposj vertbrl carotid,A,,17.95,3.31,NA,3.31,,4.58,25.84,25.84,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,40435693,,Art trnsposj subclavian,A,,15.34,3.73,NA,3.73,,3.91,22.98,22.98,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,40535694,,Art trnsposj subclav carotid,A,,18.80,3.38,NA,3.38,,4.80,26.98,26.98,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,40635695,,Art trnsposj carotid subclav,A,,19.56,3.44,NA,3.44,,4.98,27.98,27.98,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780
9904412,TX,11,DALLAS,1.009,0.996,0.858