35515 Arterial bypass Medicare reimbursement rates in Massachusetts

Code 35515 represents an open bypass that routes arterial blood from the subclavian artery to a vertebral artery, creating an alternate pathway around an obstructed or inadequate segment. Vascular surgeons perform it in the operating room for selected patients with compromised vertebral circulation, including cases associated with subclavian steal physiology. The defining feature is the named inflow and outflow vessels, not simply treatment of arm ischemia or any operation near the neck.

Report this code when operative documentation supports the subclavian-to-vertebral bypass; distinguish it from bypasses whose outflow is the carotid, axillary, or another vessel. Document laterality, anastomotic endpoints, indication, and the bypass performed. The 90-day global includes the day-before preoperative visit and related postoperative care through day 90. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others at 50%. For bilateral work, modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons are paid only with supporting documentation, and team surgery is not permitted.