Billing code 35535: Renal artery bypassMedicare rate & RVUs in Guam
Report this surgical bypass when a vein graft carries blood from the hepatic artery to a renal artery to restore kidney perfusion.
CMS doesn’t publish an office rate for 35535 in Guam.
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 35535 covers
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.
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 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $1,617.36 |
How the 35535 rate is calculated
Each of 35535’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 · 35535
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 37.18Practice expense 5.04Malpractice 9.52
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 35535
35535 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 35535
Renal artery bypass
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| 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. |
| Split (54/55/56) | 0.09/0.84/0.07 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 35535
Renal artery bypass
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
35535 without 50 · national facility
$1,728.16
Renal artery bypass
35535-50 · Bilateral: 150%
$2,592.24
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
35535 compared with similar codes
Compare codes
35535 vs 35536 vs 35560 vs 35531: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 35536Arterial bypass
- Both involve a vein graft supplying a renal artery. Choose 35535 for hepatic artery inflow and 35536 for splenic artery inflow.
- 35560Renal bypass
- Choose 35535 when the vein graft begins at the hepatic artery; choose 35560 when it begins at the aorta.
- 35531Visceral bypass
- 35531 describes a vein bypass from the aorta to a celiac or mesenteric artery. This code describes hepatic artery inflow to a renal artery.
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 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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