Billing code 35634: Arterial bypassMedicare rate & RVUs in Oklahoma
Open bypass from an iliac artery to a renal artery using a non-vein conduit is reported for selected renal revascularization procedures.
CMS doesn’t publish an office rate for 35634 in Oklahoma.
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 35634 covers
A vascular surgeon creates a grafted route from an iliac artery to a renal artery to improve blood flow to the kidney. This open operation may be performed for selected renal artery disease, such as stenosis associated with impaired renal perfusion or renovascular hypertension. Code 35634 identifies the iliorenal route using a conduit other than vein, such as a prosthetic graft. It is generally performed in a hospital operating room.
Select the code from the documented inflow artery, renal artery target, and conduit. The operative report should identify the bypass route and graft material; a vein conduit is represented by a different code. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeons require 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.
35634 in Oklahoma
| Payment locality | Office | Facility |
|---|---|---|
| Oklahoma | Unavailable | $1,523.07 |
How the 35634 rate is calculated
Each of 35634’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 · 35634
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 34.45Practice expense 4.82Malpractice 8.81
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 35634
35634 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 35634
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 · 35634
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
35634 without 50 · national facility
$1,605.92
Arterial bypass
35634-50 · Bilateral: 150%
$2,408.88
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).
35634 compared with similar codes
Compare codes
35634 vs 35535 vs 35631 vs 35633: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 35535Renal artery bypass
- Both describe an ilio-renal bypass route. Choose 35535 when the conduit is vein; 35634 is for a conduit other than vein.
- 35631Aortic bypass
- 35631 describes an aortic-origin bypass to celiac, mesenteric, or renal arteries. Use 35634 for an iliac-origin bypass specifically to a renal artery.
- 35633Arterial bypass
- 35633 is an iliac-to-mesenteric bypass. The iliac origin is shared, but 35634 targets a renal artery.
35634 billing questions
When should 35634 be selected instead of the vein-graft code?
Use 35634 for an ilio-renal bypass made with a conduit other than vein. The corresponding vein-graft route is reported with 35535.
What documentation supports 35634?
The operative report should establish the iliac inflow, renal artery target, and use of a non-vein conduit. It should also describe the bypass performed.
How is a bilateral ilio-renal bypass reported?
When the procedure is bilateral, report modifier 50 as appropriate; CMS pays the bilateral procedure at 150%.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation, and CMS does not permit team-surgery payment for this service.
How does the 90-day global period affect postoperative billing?
The global period includes the day-before preoperative visit and 90 days of related postoperative care.
What happens when another procedure is performed in the same session?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.
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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