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CMS RVU26D · Effective 2026-10-01

34520 Venous bypass Medicare reimbursement rates in Massachusetts

Reports a surgically created crossover vein graft that reroutes lower-extremity venous blood flow around an obstruction into the opposite-side venous system. Compare 34520 office and facility rates across CMS payment localities in Massachusetts.

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 34520 in Massachusetts?

Massachusetts has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.

Office / nonfacility

No supported rate

Facility setting

$887.13–$934.38

2 of 2 localities have a supported rate.

Lowest: Rest Of Massachusetts

Highest: Metropolitan Boston

A spread of $47.25 per service.

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.

Find 34520 in your payment locality →

Vascular surgery

About 34520: Lower-extremity crossover vein graft

Reports a surgically created crossover vein graft that reroutes lower-extremity venous blood flow around an obstruction into the opposite-side venous system.

A vascular surgeon creates a vein-graft pathway across the midline to reroute blood from an obstructed lower-extremity venous outflow into the opposite-side venous system. A typical clinical setting is chronic unilateral iliac venous obstruction when a crossover bypass, such as a Palma-Dale-type operation, is selected. The operative record should identify the obstruction, the veins used for inflow and outflow, the graft route, and the anastomoses.

Report this code for the crossover venous graft procedure, not simply for vein harvest or a valve repair. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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% reduction. A bilateral procedure reported with modifier 50 is paid at 150%. Assistant-at-surgery services may be paid; co-surgeons are paid only with supporting documentation. Team surgery is not permitted.

CMS billing rules for 34520

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 RVU18.70 · 69%
  • Practice expense (office) RVU3.57 · 13%
  • Malpractice RVU4.77 · 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.

34520 compared with similar codes

Office rates for Massachusetts, from the same CMS release.

34501

Venous valve repair

Femoral vein

No office rate

Choose 34501 for repair of a femoral vein valve. Choose 34520 when the operation creates a crossover vein graft to reroute lower-extremity venous flow.

34510

Vein valve transposition

Lower-extremity valve transfer

No office rate

Code 34510 describes transposition of a vein valve; 34520 describes a crossover graft bypassing an obstruction.

34502

Cava reconstruction

Any reconstruction method

No office rate

Code 34502 concerns vena cava reconstruction. Code 34520 is for a crossover graft connecting lower-extremity venous outflow across the midline.

Compare 34520 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.

2 of 2 payment localities

Office and facility base rates · shared scale starting at $0

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34520 billing questions

When is this code appropriate instead of a venous valve procedure?

Use it for a crossover vein graft that reroutes lower-extremity venous flow. Codes 34501 and 34510 describe procedures directed at a femoral vein valve.

Does a crossover graft automatically require modifier 50?

No. The graft crosses between sides as part of the procedure; that fact alone does not make the service bilateral. CMS pays a bilateral procedure reported with modifier 50 at 150%.

What operative details support reporting this code?

Document the venous obstruction, the inflow and outflow vessels, the graft route across the midline, and the anastomoses. The record should establish that a crossover graft was created.

How does the 90-day global period affect postoperative billing?

The day-before preoperative visit and 90 days of related postoperative care are included in the global period. The period applies to care related to this major surgery.

How are other procedures in the same session paid?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery services may be paid. Co-surgeons are paid only when supporting documentation is submitted; 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.

RVUs for 34520PPRRVU2026_Oct_nonQPP.csv, line 4,198 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet