No office rate
Both involve a vein graft supplying a renal artery. Choose 35535 for hepatic artery inflow and 35536 for splenic artery inflow.
On this page
CMS RVU26D · Effective 2026-10-01
35535 Renal artery bypass Medicare reimbursement rates in Delaware
Report this surgical bypass when a vein graft carries blood from the hepatic artery to a renal artery to restore kidney perfusion. Compare 35535 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 35535 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
$1700.24
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 35535: Hepatic-to-renal artery vein bypass graft
Report this surgical bypass when a vein graft carries blood from the hepatic artery to a renal artery to restore kidney perfusion.
This operation creates a new arterial route to a kidney using the hepatic artery as the inflow source and a vein graft as the conduit. A vascular surgeon typically performs it in a hospital operating room for renal artery disease that requires surgical restoration of blood flow. The operative report should identify the hepatic and renal artery connections and the vein used for the graft.
Select this code by the arteries joined, not merely by the fact that the kidney receives a bypass. An aortic or splenic artery inflow calls for a different bypass code. CMS assigns a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care. When eligible procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. A qualifying bilateral procedure reported with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons require supporting documentation. Team surgery is not permitted.
CMS billing rules for 35535
- 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 RVU37.18 · 72%
- Practice expense (office) RVU5.04 · 10%
- Malpractice RVU9.52 · 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.
35535 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
Choose 35535 when the vein graft begins at the hepatic artery; choose 35560 when it begins at the aorta.
No office rate
35531 describes a vein bypass from the aorta to a celiac or mesenteric artery. This code describes hepatic artery inflow to a renal artery.
Compare 35535 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
$1700.24
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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 35535 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
4,351
- Code
- 35535
- Physician work
- 37.18
- Practice expense
- 5.04
- Malpractice
- 9.52
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 37.18 | × 1.005 | 37.3659 |
| Practice expense | 5.04 | × 0.988 | 4.9795 |
| Malpractice | 9.52 | × 0.899 | 8.5585 |
| Total RVUs | 50.9039 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$1700.24
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 37.18 | 1.005 |
| Practice expense | 5.04 | 0.988 |
| Malpractice | 9.52 | 0.899 |
(37.18 × 1.005 + 5.04 × 0.988 + 9.52 × 0.899) × $33.4009 = $1700.24
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.
35535 billing questions
How is this different from an aortorenal bypass?
This graft starts at the hepatic artery. An aortorenal vein bypass starts at the aorta and is reported with 35560.
Does a splenic-to-renal artery bypass use this code?
No. A vein graft from the splenic artery to a renal artery is reported with 35536.
What should the operative report show?
It should identify the hepatic artery as the inflow, the renal artery as the outflow, and the vein graft connecting them.
How does CMS handle another procedure in the same session?
Under the standard multiple-procedure reduction, CMS pays the highest-valued eligible procedure in full and other eligible procedures at 50%.
Can an assistant or co-surgeon be paid for this bypass?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, while team surgery is not permitted.
What care is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
4,3483552F,,Hgh risk for 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
4,34935531,,Art byp grft aorcel/aormesen,A,,38.13,5.10,NA,5.10,,9.77,53.00,53.00,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,35035533,,Art byp grft axill/fem/fem,A,,29.17,4.39,NA,4.39,,7.45,41.01,41.01,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,35135535,,Art byp grft hepatorenal,A,,37.18,5.04,NA,5.04,,9.52,51.74,51.74,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,35235536,,Art byp grft splenorenal,A,,32.89,4.68,NA,4.68,,8.40,45.97,45.97,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,35335537,,Art byp grft aortoiliac,A,,40.83,5.35,NA,5.35,,10.46,56.64,56.64,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,35435538,,Art byp grft aortobi-iliac,A,,45.85,5.82,NA,5.82,,11.75,63.42,63.42,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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