Billing code 35626: Arterial bypassMedicare rate & RVUs in Illinois
Reports an aorta-origin bypass using a non-vein conduit to revascularize the subclavian, innominate, or carotid artery.
CMS doesn’t publish an office rate for 35626 in Illinois.
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 35626 covers
This open vascular operation routes blood from the aorta to a subclavian, innominate, or carotid artery using a conduit other than vein. Vascular and cardiothoracic surgeons may perform it to restore flow when disease or reconstruction affects an aortic arch branch. The operative report should identify the aortic origin, the specific target artery, and the conduit used.
Select this code when the documented bypass has the aorta as its inflow and one of the named arteries as its outflow, and a non-vein conduit is used. A vein conduit points to the corresponding vein-graft code, 35526. CMS classifies this as major surgery with a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team-surgery payment 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.
Where 35626 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $1,794.40 |
| East St. Louis | Unavailable | $1,696.35 |
| Rest Of Illinois | Unavailable | $1,588.07 |
| Suburban Chicago | Unavailable | $1,677.78 |
How the 35626 rate is calculated
Each of 35626’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 · 35626
RVUs × geographic indexes × conversion factor
Work28.41
28.41 RVUs× 1.000 GPCI
Practice expense8.89
8.89 RVUs× 1.000 GPCI
Malpractice7.05
7.05 RVUs× 1.000 GPCI
Adjusted RVUs
44.3500
Conversion factor
$33.4009
Medicare rate
$1,481.33
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 35626
35626 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 35626
Arterial 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 · 35626
Arterial 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
35626 without 50 · national facility
$1,481.33
Arterial bypass
35626-50 · Bilateral: 150%
$2,222.00
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).
35626 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 35526Arterial bypass
- The inflow and target arteries are comparable, but 35526 is selected for a vein conduit; this code is for a conduit other than vein.
- 35606Arterial bypass
- 35606 describes a carotid-to-subclavian bypass. This code requires the aorta as the bypass origin and a subclavian, innominate, or carotid target.
- 35642Arterial bypass
- 35642 connects a carotid artery with a vertebral artery; this code routes flow from the aorta to a subclavian, innominate, or carotid artery.
35626 billing questions
When should I choose this code instead of 35526?
Use this code when the aorta-to-subclavian, innominate, or carotid bypass uses a non-vein conduit. Code 35526 describes the corresponding bypass using vein.
What operative details support reporting this code?
The report should establish the aorta as the inflow source, identify the subclavian, innominate, or carotid target, and document use of a non-vein conduit.
Can I report a separate bypass code for the same graft?
Do not report another bypass code to describe the same graft. A separately performed bypass with a different origin and target should be evaluated from its own operative details.
How does the multiple-procedure payment rule affect this code?
When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are paid at 50%.
How are bilateral procedures and surgical assistance handled?
Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team-surgery payment 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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