No office rate
Choose 35518 when the graft connects the two axillary arteries. Choose 35516 when the bypass runs from a subclavian artery to an axillary artery.
On this page
CMS RVU26D · Effective 2026-10-01
35518 Arterial bypass Medicare reimbursement rates in Colorado
Reports open graft bypass from one axillary artery to the other, commonly routing blood around an obstructed subclavian artery. Compare 35518 office and facility rates across CMS payment localities in Colorado.
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 35518 in Colorado?
Colorado has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1013.33
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
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.
Vascular surgery
About 35518: Axillary-to-axillary arterial bypass
Reports open graft bypass from one axillary artery to the other, commonly routing blood around an obstructed subclavian artery.
A vascular surgeon creates an extra-anatomic route between the axillary arteries, typically across the chest, to improve blood flow when the usual arterial pathway is obstructed. This operation is commonly considered for symptomatic subclavian artery occlusive disease when the axillary arteries provide suitable inflow and outflow. The graft may be prosthetic or another documented conduit; the operative report should identify its route and both anastomotic vessels.
Choose this code when the bypass runs from axillary artery to axillary artery, rather than from a subclavian artery or to an arm or leg artery. The 90-day global period includes the day-before preoperative visit and related postoperative care through day 90. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures at 50%. Modifier 50 pricing is 150% for a bilateral procedure. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 35518
- 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 RVU22.08 · 71%
- Practice expense (office) RVU3.38 · 11%
- Malpractice RVU5.63 · 18%
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.
35518 compared with similar codes
Office rates for Colorado, from the same CMS release.
No office rate
35511 describes a subclavian-to-subclavian route. This code requires axillary arteries as both bypass endpoints.
No office rate
35521 routes blood from an axillary artery to a femoral artery. This code connects one axillary artery to the other.
No office rate
35522 ends at a brachial artery. Use this code when the bypass outflow is the opposite axillary artery.
Compare 35518 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.
1 of 1 payment localities
Colorado →
Office / nonfacility
Unavailable
Facility
$1013.33
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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 35518 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
4,341
- Code
- 35518
- Physician work
- 22.08
- Practice expense
- 3.38
- Malpractice
- 5.63
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 22.08 | × 1.012 | 22.3450 |
| Practice expense | 3.38 | × 1.064 | 3.5963 |
| Malpractice | 5.63 | × 0.781 | 4.3970 |
| Total RVUs | 30.3383 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Colorado$1013.33
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 22.08 | 1.012 |
| Practice expense | 3.38 | 1.064 |
| Malpractice | 5.63 | 0.781 |
(22.08 × 1.012 + 3.38 × 1.064 + 5.63 × 0.781) × $33.4009 = $1013.33
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.
35518 billing questions
How do I distinguish this from a subclavian-to-axillary bypass?
Use this code when both bypass endpoints are axillary arteries. A bypass beginning at a subclavian artery and ending at an axillary artery is a different configuration.
What operative documentation supports this code?
Document the bypass indication, the donor and recipient arteries, the graft route, and the conduit used. The record should make clear that the graft connects axillary artery to axillary artery.
Does the 90-day global include postoperative visits?
Yes. The day-before preoperative visit and related postoperative care through 90 days are included in the global period.
How is this code priced with other procedures in the same session?
The highest-valued procedure is paid in full, and other procedures are paid at 50%. For a bilateral procedure reported with modifier 50, the CMS pricing rule is 150%.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires 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 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.
4,33835512,,Art byp grft subclav-brchial,A,,23.29,3.60,NA,3.60,,5.96,32.85,32.85,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,33935515,,Art byp grft subclav-vertbrl,A,,25.44,4.33,NA,4.33,,6.49,36.26,36.26,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,34035516,,Art byp grft subclav-axilary,A,,23.60,3.60,NA,3.60,,6.03,33.23,33.23,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,34135518,,Art byp grft axillary-axilry,A,,22.08,3.38,NA,3.38,,5.63,31.09,31.09,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,3423551F,,Intrmed rsk thromboembolism,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4,34335521,,Art byp grft axill-femoral,A,,23.53,3.95,NA,3.95,,6.02,33.50,33.50,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,34435522,,Art byp grft axill-brachial,A,,22.57,3.54,NA,3.54,,5.76,31.87,31.87,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899