No office rate
Both bypass to the vertebral artery using a non-vein conduit. Choose by the documented donor artery: carotid for 35642, subclavian for 35645.
On this page
CMS RVU26D · Effective 2026-10-01
35645 Arterial bypass Medicare reimbursement rates in Indiana
Open bypass using a non-vein conduit from the subclavian artery to the vertebral artery to restore blood flow in selected vascular disease. Compare 35645 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 35645 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
$777.37
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 35645: Subclavian-to-vertebral artery bypass
Open bypass using a non-vein conduit from the subclavian artery to the vertebral artery to restore blood flow in selected vascular disease.
This open operation creates a route for blood from the subclavian artery into the vertebral artery using a conduit other than vein. Vascular surgeons may perform it when vertebral artery flow needs surgical restoration, including selected cases of impaired circulation to the posterior brain. The operation typically requires exposure in the neck and upper chest and is performed in an operating room.
Report this code when the documented donor and recipient vessels are the subclavian and vertebral arteries and the conduit is not vein. The operative report should establish the bypass anatomy, conduit, side, and clinical indication. The CMS 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same 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 made; co-surgeon payment requires supporting documentation, and team-surgery payment is not permitted.
CMS billing rules for 35645
- 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 RVU17.97 · 69%
- Practice expense (office) RVU3.31 · 13%
- Malpractice RVU4.60 · 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.
35645 compared with similar codes
Office rates for Indiana, from the same CMS release.
No office rate
Both involve a subclavian donor artery and a non-vein conduit, but 35612 ends at the opposite subclavian artery rather than the vertebral artery.
Compare 35645 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
$777.37
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 35645 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
4,387
- Code
- 35645
- Physician work
- 17.97
- Practice expense
- 3.31
- Malpractice
- 4.60
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 17.97 | × 1.000 | 17.9700 |
| Practice expense | 3.31 | × 0.927 | 3.0684 |
| Malpractice | 4.60 | × 0.486 | 2.2356 |
| Total RVUs | 23.2740 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Indiana$777.37
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 17.97 | 1 |
| Practice expense | 3.31 | 0.927 |
| Malpractice | 4.6 | 0.486 |
(17.97 × 1 + 3.31 × 0.927 + 4.6 × 0.486) × $33.4009 = $777.37
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.
35645 billing questions
How does this differ from 35545?
Both codes describe a subclavian-to-vertebral bypass, but 35545 is for a vein conduit. Use 35645 when the conduit is other than vein.
When would 35642 be considered instead?
35642 describes a carotid-to-vertebral bypass. The donor artery documented in the operative report distinguishes it from this subclavian-origin bypass.
Are the anastomoses or surgical exposure separately represented?
The reported service is the completed bypass between the named arteries. Do not treat its component steps as separate bypasses.
How is bilateral reporting handled?
When the procedure is performed bilaterally, CMS lists modifier 50 payment at 150%. The record should support the work on both sides.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team-surgery payment is not permitted under the listed CMS rules.
What postoperative care falls within the global period?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
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.
4,38435637,,Bpg aortoiliac,A,,32.22,4.67,NA,4.67,,8.25,45.14,45.14,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,38535638,,Bpg aortobi-iliac,A,,32.76,6.30,NA,6.30,,8.28,47.34,47.34,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,38635642,,Bpg carotid-vertebral,A,,18.47,3.90,NA,3.90,,4.72,27.09,27.09,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,38735645,,Bpg subclavian-vertebral,A,,17.97,3.31,NA,3.31,,4.60,25.88,25.88,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,38835646,,Bpg aortobifemoral,A,,32.16,5.87,NA,5.87,,8.17,46.20,46.20,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,38935647,,Bpg aortofemoral,A,,28.99,4.28,NA,4.28,,7.42,40.69,40.69,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,39035650,,Bpg axillary-axillary,A,,19.66,3.20,NA,3.20,,5.02,27.88,27.88,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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