No office rate
Both codes involve a vertebral artery recipient. Choose 35508 for carotid inflow and 35515 for subclavian inflow.
On this page
CMS RVU26D · Effective 2026-10-01
35508 Arterial bypass Medicare reimbursement rates in Michigan
Reports a vein-graft bypass connecting a carotid artery to a vertebral artery when surgical revascularization is needed for compromised vertebral circulation. Compare 35508 office and facility rates across CMS payment localities in Michigan.
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 35508 in Michigan?
Michigan 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
$1226.50–$1354.76
2 of 2 localities have a supported rate.
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 35508: Carotid-to-vertebral artery bypass graft
Reports a vein-graft bypass connecting a carotid artery to a vertebral artery when surgical revascularization is needed for compromised vertebral circulation.
The vascular surgeon creates a bypass from a carotid artery to a vertebral artery using a vein graft, routing blood around an obstructed or otherwise inadequate arterial segment. This reconstruction may be considered for selected patients with vertebrobasilar circulation problems when the carotid artery can provide inflow and the vertebral artery is an appropriate recipient. The procedure is generally performed in an operating room under surgical exposure of the vessels.
Select this code when the operative report identifies the carotid artery as the inflow vessel and the vertebral artery as the bypass destination. Documentation should establish the indication, the origin and endpoint of the graft, the conduit used, and the completed reconstruction. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 applies to bilateral performance, 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 35508
- 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 RVU25.44 · 70%
- Practice expense (office) RVU4.33 · 12%
- Malpractice RVU6.49 · 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.
35508 compared with similar codes
Office rates for Michigan, from the same CMS release.
No office rate
This code describes a subclavian-to-carotid bypass, not a carotid-to-vertebral reconstruction.
No office rate
This code describes a carotid bypass involving the contralateral carotid artery; 35508 requires a vertebral artery destination.
Compare 35508 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
Detroit →
Office / nonfacility
Unavailable
Facility
$1354.76
Rest Of Michigan →
Office / nonfacility
Unavailable
Facility
$1226.50
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35508 billing questions
How is this code distinguished from a subclavian-to-vertebral bypass?
Use 35508 when the carotid artery supplies the bypass and the vertebral artery is the destination. A subclavian-to-vertebral reconstruction is reported with 35515.
What operative details support reporting 35508?
The operative report should identify the carotid inflow, vertebral recipient, vein conduit, indication, and completed bypass route.
Does the 90-day global period include routine postoperative care?
Yes. The global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
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.
How does Medicare treat bilateral performance?
When the procedure is performed bilaterally and modifier 50 is used, CMS pays it at 150%.
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.
4,33035500,,Harvest vein for bypass,A,,6.28,0.73,NA,0.73,,1.58,8.59,8.59,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,33135501,,Art byp grft ipsilat carotid,A,,28.36,4.11,NA,4.11,,7.26,39.73,39.73,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,33235506,,Art byp grft subclav-carotid,A,,24.70,3.69,NA,3.69,,6.31,34.70,34.70,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,33335508,,Art byp grft carotid-vertbrl,A,,25.44,4.33,NA,4.33,,6.49,36.26,36.26,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,33435509,,Art byp grft contral carotid,A,,27.39,4.06,NA,4.06,,7.01,38.46,38.46,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,3353550F,,Low 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
4,33635510,,Art byp grft carotid-brchial,A,,23.78,3.63,NA,3.63,,6.08,33.49,33.49,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00