No office rate
Choose 35522 when the graft runs from the axillary artery to the brachial artery. Choose 35512 when it runs from the subclavian artery to the brachial artery.
On this page
CMS RVU26D · Effective 2026-10-01
35522 Arterial bypass Medicare reimbursement rates in Delaware
Open vein-graft bypass from the axillary artery to the brachial artery reroutes upper-extremity blood flow around an obstructed segment. Compare 35522 office and facility rates across CMS payment localities in Delaware.
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 35522 in Delaware?
Delaware 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
$1047.41
1 of 1 localities have a supported rate.
Payment area: Delaware
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 35522: Axillary-to-brachial vein bypass
Open vein-graft bypass from the axillary artery to the brachial artery reroutes upper-extremity blood flow around an obstructed segment.
A vascular surgeon creates a vein-graft route from the axillary artery to the brachial artery to restore blood flow to the arm when disease obstructs the native arterial pathway. The operation is generally performed in a hospital or other surgical facility for patients with upper-extremity ischemia from arterial occlusive disease. The documented inflow and outflow sites distinguish this operation from bypasses beginning at the subclavian artery or ending in the forearm.
Report the code for the axillary-to-brachial bypass, documenting the side, target vessels, conduit, indication, and operative work. A separately performed vein harvest may be reported with 35500 when applicable. The day-before preoperative visit and 90 days of related postoperative care are included. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 identifies bilateral work and is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 35522
- 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 RVU22.57 · 71%
- Practice expense (office) RVU3.54 · 11%
- Malpractice RVU5.76 · 18%
44
Medicare services in 2024 · #5431 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.
35522 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
35516 describes a subclavian-to-axillary bypass; 35522 has the brachial artery as its outflow target.
No office rate
35518 connects axillary arteries across the body, while 35522 connects an axillary artery to a brachial artery.
No office rate
35523 is for a bypass involving the brachial and radial or ulnar arteries in the forearm, rather than an axillary-to-brachial route.
Compare 35522 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
Delaware →
Office / nonfacility
Unavailable
Facility
$1047.41
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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 35522 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
4,344
- Code
- 35522
- Physician work
- 22.57
- Practice expense
- 3.54
- Malpractice
- 5.76
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 22.57 | × 1.005 | 22.6828 |
| Practice expense | 3.54 | × 0.988 | 3.4975 |
| Malpractice | 5.76 | × 0.899 | 5.1782 |
| Total RVUs | 31.3586 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$1047.41
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 22.57 | 1.005 |
| Practice expense | 3.54 | 0.988 |
| Malpractice | 5.76 | 0.899 |
(22.57 × 1.005 + 3.54 × 0.988 + 5.76 × 0.899) × $33.4009 = $1047.41
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.
35522 billing questions
How is this different from 35512?
This code describes a bypass originating at the axillary artery and ending at the brachial artery. Code 35512 is for a subclavian-to-brachial bypass.
When would 35500 be reported with this bypass?
When a separate upper-extremity vein harvest for the bypass is performed and reportable, 35500 may be reported with the bypass.
What operative details support code selection?
Document the side, axillary inflow, brachial outflow, vein conduit, indication, and bypass performed. Those vessel endpoints distinguish this code from nearby bypass configurations.
How is bilateral work reported?
Report bilateral work with modifier 50; CMS payment for the bilateral procedure is 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment may be made. 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.
4,34135518,,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
4,34535523,,Art byp grft brchl-ulnr-rdl,A,,23.53,3.98,NA,3.98,,6.02,33.53,33.53,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,34635525,,Art byp grft brachial-brchl,A,,21.15,3.42,NA,3.42,,5.40,29.97,29.97,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,34735526,,Art byp grft aor/carot/innom,A,,30.76,10.80,NA,10.80,,7.38,48.94,48.94,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503