Billing code 35390: Carotid reoperationMedicare rate & RVUs in Alaska
Reports the added work of repeat carotid endarterectomy in a previously operated neck, alongside the primary code for the new carotid endarterectomy.
CMS doesn’t publish an office rate for 35390 in Alaska.
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 9 sections
What 35390 covers
This add-on represents the additional operative work of performing carotid endarterectomy in a neck that has already undergone carotid surgery. A vascular surgeon may encounter this situation when treating recurrent narrowing at a previously operated carotid artery. The repeat operation involves working through the prior surgical field to address the recurrent disease; it is not simply another code for an initial carotid endarterectomy.
Report 35390 with the primary code for the carotid endarterectomy, generally 35301. The operative report should establish the prior carotid operation and document the current repeat endarterectomy. CMS treats this as an add-on: it is reported only with a primary procedure, and its payment falls within that procedure’s global period. Do not report it by itself to describe the repeat operation.
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.
35390 in Alaska*
| Payment locality | Office | Facility |
|---|---|---|
| Alaska* | Unavailable | $184.23 |
How the 35390 rate is calculated
Each of 35390’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 · 35390
RVUs × geographic indexes × conversion factor
Work3.11
3.11 RVUs× 1.000 GPCI
Practice expense0.39
0.39 RVUs× 1.000 GPCI
Malpractice0.79
0.79 RVUs× 1.000 GPCI
Adjusted RVUs
4.2900
Conversion factor
$33.4009
Medicare rate
$143.29
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 35390
The CMS indicators that decide how 35390 is paid alongside other services.
CMS payment indicators · 35390
Carotid reoperation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 80 · payment effect
With and without the modifier
35390 without 80 · national facility
$143.29
Carotid reoperation
35390-80 · Assistant: 16%
$22.93
A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.
35390 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 35301Arterial endarterectomy
- 35301 reports the primary carotid endarterectomy. Add 35390 only when that operation is a reoperation in a previously operated carotid field.
- 37215Transcath stent cca w/eps
- 37215 reports carotid stent placement with embolic protection, an endovascular approach rather than repeat open endarterectomy.
- 37216Transcath stent cca w/o eps
- 37216 reports carotid stent placement without embolic protection. It describes an endovascular treatment, not reoperative carotid endarterectomy.
35390 billing questions
When should 35390 be reported with 35301?
Report it when the current carotid endarterectomy is a reoperation in a previously operated carotid field. Code 35301 describes the primary endarterectomy; 35390 captures the added reoperative work.
Can 35390 be submitted without a primary procedure code?
No. It is an add-on code and must be reported with the primary carotid endarterectomy procedure.
What documentation supports the add-on?
The operative report should identify the prior carotid operation and describe the current repeat endarterectomy in that previously operated field.
Is 35390 used for an initial carotid endarterectomy?
No. An initial carotid endarterectomy is reported with the applicable primary procedure code; 35390 represents reoperative work.
How does the global-period rule affect payment?
CMS pays this add-on within the global period of the primary procedure. It is not a separately reportable stand-alone service.
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
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