35501 Carotid bypass Medicare reimbursement rates in Hawaii

A vascular surgeon uses a vein graft to create a new blood-flow route between carotid artery segments on the same side of the neck. The operation may be considered when disease, injury, or another lesion prevents adequate flow through the native carotid segment. It is generally performed in a hospital operating room. The operative report should identify the side, the carotid segments joined, the graft material, and the reason for bypass.

Report this code for the ipsilateral carotid-to-carotid configuration; a bypass connecting different named arteries or the opposite carotid side is represented by a different code. If a vein is separately harvested for the graft, review the applicable harvest code and documentation. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.