No office rate
35522 describes an axillary-to-brachial bypass. Choose 35523 when the bypass instead runs from the brachial artery to a radial or ulnar artery.
On this page
CMS RVU26D · Effective 2026-10-01
35523 Arterial bypass Medicare reimbursement rates in Indiana
Reports a vein-graft bypass from the brachial artery to a radial or ulnar artery to restore blood flow through the forearm and hand. Compare 35523 office and facility rates across CMS payment localities in Indiana.
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 35523 in Indiana?
Indiana 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
$1006.88
1 of 1 localities have a supported rate.
Payment area: Indiana
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 35523: Brachial to forearm artery vein bypass
Reports a vein-graft bypass from the brachial artery to a radial or ulnar artery to restore blood flow through the forearm and hand.
A vascular surgeon uses a vein graft to route blood from the brachial artery to the radial or ulnar artery. The operation may be performed for upper-extremity arterial occlusive disease causing inadequate forearm or hand perfusion. The operative report should identify the brachial inflow artery, the radial or ulnar outflow target, and the vein conduit used. The code describes the bypass reconstruction, not vein harvest by itself.
Select this code when the bypass begins at the brachial artery and ends at a radial or ulnar artery; the documented anastomosis sites distinguish it from other upper-extremity bypass codes. A separate vein harvest may be reported when performed and supported by the record. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care for 90 days. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 35523
- 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 RVU23.53 · 70%
- Practice expense (office) RVU3.98 · 12%
- Malpractice RVU6.02 · 18%
50
Medicare services in 2024 · #5354 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.
35523 compared with similar codes
Office rates for Indiana, from the same CMS release.
No office rate
35525 is for a brachial-to-brachial bypass. For a brachial inflow with radial or ulnar outflow, use 35523.
No office rate
35500 describes vein harvest for bypass, rather than the arterial bypass reconstruction from the brachial artery to a forearm artery.
Compare 35523 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
Indiana →
Office / nonfacility
Unavailable
Facility
$1006.88
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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 35523 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
4,345
- Code
- 35523
- Physician work
- 23.53
- Practice expense
- 3.98
- Malpractice
- 6.02
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 23.53 | × 1.000 | 23.5300 |
| Practice expense | 3.98 | × 0.927 | 3.6895 |
| Malpractice | 6.02 | × 0.486 | 2.9257 |
| Total RVUs | 30.1452 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Indiana$1006.88
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 23.53 | 1 |
| Practice expense | 3.98 | 0.927 |
| Malpractice | 6.02 | 0.486 |
(23.53 × 1 + 3.98 × 0.927 + 6.02 × 0.486) × $33.4009 = $1006.88
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.
35523 billing questions
How do I distinguish this from a brachial-to-brachial bypass?
Use 35523 when the distal target is the radial or ulnar artery. A brachial artery target calls for the brachial-to-brachial code 35525.
Is vein harvest included in this bypass code?
The code describes the bypass using a vein conduit. A separately performed vein harvest may be reported with 35500 when supported by the operative documentation.
What operative details support selection of 35523?
Document the brachial inflow, whether the outflow target is radial or ulnar, and the vein graft used to create the bypass.
How does Medicare handle other procedures performed in the same session?
The highest-valued procedure is paid in full, and other procedures are paid at 50% under the standard multiple-procedure reduction.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. 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.
4,3423551F,,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
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
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915