Billing code 35539: Aortic bypassMedicare rate & RVUs in Nevada
Reports an aorta-to-one-femoral-artery bypass using a vein conduit, typically to restore lower-extremity blood flow in aortoiliac occlusive disease.
CMS doesn’t publish an office rate for 35539 in Nevada.
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 35539 covers
A vascular surgeon routes a vein graft from the aorta to a femoral artery to bypass obstructed inflow and improve blood supply to one lower extremity. The operation is generally performed in a hospital operating room for significant aortoiliac occlusive disease, such as ischemia associated with rest pain or tissue loss. The operative report should establish the aortic origin, the single femoral outflow target, and use of a vein conduit.
Select this code when the documented reconstruction has one femoral target; an aortic reconstruction with two femoral outflows is distinguished by code 35540. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during the following 90 days. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures at 50%. CMS lists bilateral reporting with modifier 50 at 150%. Assistant-at-surgery payment may be allowed; 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.
35539 in Nevada**
| Payment locality | Office | Facility |
|---|---|---|
| Nevada** | Unavailable | $1,927.46 |
How the 35539 rate is calculated
Each of 35539’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 · 35539
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 43.01Practice expense 5.52Malpractice 11.01
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 35539
35539 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 35539
Aortic 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 · 35539
Aortic 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
35539 without 50 · national facility
$1,988.69
Aortic bypass
35539-50 · Bilateral: 150%
$2,983.04
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).
35539 compared with similar codes
Compare codes
35539 vs 35540 vs 35537 vs 35538 vs 35521: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 35540Aortic bypass
- Use 35540 when the aortic reconstruction supplies both femoral arteries. Code 35539 describes a single femoral outflow target.
- 35537Aortoiliac bypass
- 35537 ends at an iliac artery; 35539 ends at a femoral artery. Follow the documented distal target.
- 35538Aortic bypass
- 35538 supplies both iliac arteries from the aorta. It is distinct from the single femoral outflow described by 35539.
- 35521Arterial bypass
- 35521 uses axillary inflow for a femoral target, rather than the aortic inflow used for 35539.
35539 billing questions
How does 35539 differ from 35540?
35539 describes a vein bypass from the aorta to one femoral artery. Use 35540 for an aortic reconstruction with right and left femoral outflows.
What operative details support 35539?
The operative report should identify the aortic inflow, the single femoral artery receiving flow, and the vein conduit. It should also document the indication for the reconstruction.
Does the 90-day global period include postoperative care?
Yes. CMS includes the day-before preoperative visit and 90 days of related postoperative care in the major-surgery global period.
How are other procedures in the same session paid?
CMS pays the highest-valued procedure in full and other procedures at 50% when they are performed in the same session.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be allowed. Co-surgeon payment requires supporting documentation; CMS does not permit team surgery.
When is modifier 50 relevant?
CMS lists bilateral reporting with modifier 50 at 150%. For an aortic reconstruction with two femoral outflows, compare the documented operation with the specific sibling code 35540.
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
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