Billing code 35536: Arterial bypassMedicare rate & RVUs in Missouri
Reports surgical renal revascularization using a vein graft routed from the splenic artery to the renal artery, commonly for selected renal artery occlusive disease.
CMS doesn’t publish an office rate for 35536 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 35536 covers
A vascular surgeon uses a vein graft to create an arterial route from the splenic artery to the renal artery. The operation may be considered for renal artery occlusive disease when the splenic artery is suitable as the source of blood flow. This is an open vascular reconstruction, not a splenic-vein-to-renal-vein shunt used to manage portal hypertension. The operative report should identify the arterial inflow and outflow, the vein conduit, and the bypass performed.
Report this code when the documented bypass connects the splenic and renal arteries using a vein graft; the chosen inflow and outflow distinguish it from other renal bypass configurations. 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 one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 applies to a bilateral procedure, paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
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.
Where 35536 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City | Unavailable | $1,519.45 |
| Metropolitan St. Louis | Unavailable | $1,528.50 |
| Rest Of Missouri | Unavailable | $1,506.57 |
How the 35536 rate is calculated
Each of 35536’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 35536
RVUs × geographic indexes × conversion factor
Work32.89
32.89 RVUs× 1.000 GPCI
Practice expense4.68
4.68 RVUs× 1.000 GPCI
Malpractice8.40
8.40 RVUs× 1.000 GPCI
Adjusted RVUs
45.9700
Conversion factor
$33.4009
Medicare rate
$1,535.44
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 35536
35536 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 35536
Arterial bypass
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.84/0.07 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 35536
Arterial bypass
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
35536 without 50 · national facility
$1,535.44
Arterial bypass
35536-50 · Bilateral: 150%
$2,303.16
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
35536 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 35535Renal artery bypass
- 35535 describes a hepatorenal bypass, with hepatic rather than splenic arterial inflow to the renal artery.
- 35560Renal bypass
- 35560 uses the aorta as the inflow source for renal revascularization; this code uses splenic arterial inflow.
- 35531Visceral bypass
- 35531 describes a bypass involving the aorta and celiac or mesenteric arteries, not a splenic-to-renal artery bypass.
35536 billing questions
How is this different from a splenorenal shunt?
This code describes an arterial bypass between the splenic and renal arteries using a vein graft. A splenorenal shunt connects veins and is a different operation.
When would 35560 be reported instead?
Use 35560 for an aorta-to-renal artery bypass. The inflow vessel, rather than the renal target, distinguishes it from this splenic-to-renal bypass.
What operative documentation supports this code?
Document the renal indication, splenic arterial inflow, renal arterial outflow, and use of a vein graft. The operative description should establish the completed bypass.
Are related postoperative visits separately included?
Related postoperative care during the 90-day global period is included, as is the day-before preoperative visit.
How are other procedures in the same session handled?
The highest-valued procedure is paid in full; other procedures in the session are subject to the standard multiple-procedure reduction. Modifier 50 applies to a bilateral procedure and is paid at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. 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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
Fee sheets
Put 35536 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →