No office rate
Both describe an ilio-renal bypass route. Choose 35535 when the conduit is vein; 35634 is for a conduit other than vein.
On this page
CMS RVU26D · Effective 2026-10-01
35634 Arterial bypass Medicare reimbursement rates in California
Open bypass from an iliac artery to a renal artery using a non-vein conduit is reported for selected renal revascularization procedures. Compare 35634 office and facility rates across CMS payment localities in California.
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 35634 in California?
California has 29 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 29 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1504.39–$1667.11
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $162.72 per service.
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 35634 pays more and less in California
Vascular surgery
About 35634: Iliac-to-renal bypass with non-vein graft
Open bypass from an iliac artery to a renal artery using a non-vein conduit is reported for selected renal revascularization procedures.
A vascular surgeon creates a grafted route from an iliac artery to a renal artery to improve blood flow to the kidney. This open operation may be performed for selected renal artery disease, such as stenosis associated with impaired renal perfusion or renovascular hypertension. Code 35634 identifies the iliorenal route using a conduit other than vein, such as a prosthetic graft. It is generally performed in a hospital operating room.
Select the code from the documented inflow artery, renal artery target, and conduit. The operative report should identify the bypass route and graft material; a vein conduit is represented by a different code. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 35634
- 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 RVU34.45 · 72%
- Practice expense (office) RVU4.82 · 10%
- Malpractice RVU8.81 · 18%
24
Medicare services in 2024 · #5812 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.
35634 compared with similar codes
Office rates for California, from the same CMS release.
No office rate
35631 describes an aortic-origin bypass to celiac, mesenteric, or renal arteries. Use 35634 for an iliac-origin bypass specifically to a renal artery.
No office rate
35633 is an iliac-to-mesenteric bypass. The iliac origin is shared, but 35634 targets a renal artery.
Compare 35634 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.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield | Office Unavailable | Facility $1528.18 |
| Chico | Office Unavailable | Facility $1504.39 |
| El Centro | Office Unavailable | Facility $1505.87 |
| Fresno | Office Unavailable | Facility $1504.39 |
| Hanford-Corcoran | Office Unavailable | Facility $1504.39 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $1583.68 |
| Madera | Office Unavailable | Facility $1504.39 |
| Merced | Office Unavailable | Facility $1504.39 |
| Modesto | Office Unavailable | Facility $1504.39 |
| Napa | Office Unavailable | Facility $1584.83 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $1556.50 |
| Redding | Office Unavailable | Facility $1504.39 |
| Rest Of California | Office Unavailable | Facility $1504.39 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $1598.83 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $1537.04 |
| Salinas | Office Unavailable | Facility $1530.65 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $1537.22 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $1622.04 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $1612.03 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $1667.11 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $1626.21 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $1511.32 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $1528.15 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $1528.32 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $1540.60 |
| Stockton | Office Unavailable | Facility $1504.39 |
| Vallejo | Office Unavailable | Facility $1570.41 |
| Visalia | Office Unavailable | Facility $1504.39 |
| Yuba City | Office Unavailable | Facility $1504.39 |
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35634 billing questions
When should 35634 be selected instead of the vein-graft code?
Use 35634 for an ilio-renal bypass made with a conduit other than vein. The corresponding vein-graft route is reported with 35535.
What documentation supports 35634?
The operative report should establish the iliac inflow, renal artery target, and use of a non-vein conduit. It should also describe the bypass performed.
How is a bilateral ilio-renal bypass reported?
When the procedure is bilateral, report modifier 50 as appropriate; CMS pays the bilateral procedure at 150%.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation, and CMS does not permit team-surgery payment for this service.
How does the 90-day global period affect postoperative billing?
The global period includes the day-before preoperative visit and 90 days of related postoperative care.
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 other procedures are paid at 50%.
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.
4,37935631,,Bpg aor-celiac-msn-renal,A,,35.13,6.06,NA,6.06,,8.93,50.12,50.12,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,38035632,,Bpg ilio-celiac,A,,35.23,4.88,NA,4.88,,9.01,49.12,49.12,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,38135633,,Bpg ilio-mesenteric,A,,38.13,6.11,NA,6.11,,9.72,53.96,53.96,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,38235634,,Bpg iliorenal,A,,34.45,4.82,NA,4.82,,8.81,48.08,48.08,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,38335636,,Bpg splenorenal,A,,30.96,4.53,NA,4.53,,7.92,43.41,43.41,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,38435637,,Bpg aortoiliac,A,,32.22,4.67,NA,4.67,,8.25,45.14,45.14,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,38535638,,Bpg aortobi-iliac,A,,32.76,6.30,NA,6.30,,8.28,47.34,47.34,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00