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CMS RVU26D · Effective 2026-10-01

35616 Arterial bypass Medicare reimbursement rates in Tennessee

Reports open revascularization using a non-vein graft to route blood from the subclavian artery to the axillary artery around an obstructed segment. Compare 35616 office and facility rates across CMS payment localities in Tennessee.

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 35616 in Tennessee?

Tennessee has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.

Office / nonfacility

No supported rate

Facility setting

$908.63

1 of 1 localities have a supported rate.

Payment area: Tennessee

One mapped payment locality.

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.

Find 35616 in your payment locality →

Vascular surgery

About 35616: Subclavian-to-axillary bypass graft

Reports open revascularization using a non-vein graft to route blood from the subclavian artery to the axillary artery around an obstructed segment.

A vascular surgeon creates an alternate arterial route from the subclavian artery to the axillary artery, generally using a prosthetic rather than vein conduit. The bypass can restore upper-extremity blood flow when disease in the native arterial pathway limits circulation. This is an open operative service, typically performed in a hospital operating room; the operative report should identify the inflow and outflow arteries and the graft used.

Select the code by the bypass endpoints and the non-vein conduit, not simply by the diagnosis or the limb treated. The record should support the indication, route, and completed graft. A 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days. For multiple procedures in one session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team-surgery payment is not permitted.

CMS billing rules for 35616

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 RVU21.27 · 71%
  • Practice expense (office) RVU3.32 · 11%
  • Malpractice RVU5.43 · 18%

22

Medicare services in 2024 · #5868 by national volume

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.

35616 compared with similar codes

Office rates for Tennessee, from the same CMS release.

35606

Arterial bypass

Carotid to subclavian

No office rate

This code uses subclavian inflow and axillary outflow. Code 35606 describes a bypass from the carotid artery to the subclavian artery.

35612

Arterial bypass

Subclavian to subclavian

No office rate

This code ends at the axillary artery. Code 35612 connects one subclavian artery to the other.

35650

Arterial bypass

Axillary to axillary

No office rate

This code runs from the subclavian artery to the axillary artery. Code 35650 uses one axillary artery as inflow and the other as outflow.

35621

Arterial bypass

Axillary inflow to femoral

No office rate

This code has axillary outflow. Code 35621 carries blood from the axillary artery to the femoral artery.

Compare 35616 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.

1 of 1 payment localities

Office and facility base rates · shared scale starting at $0

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How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 35616 in Tennessee.

PPRRVU2026_Oct_nonQPP.csv

4,375

Code
35616
Physician work
21.27
Practice expense
3.32
Malpractice
5.43

GPCI2026.csv

95

Locality
Tennessee
Physician work
1.000
Practice expense
0.909
Malpractice
0.537
Facility calculation for 35616 in Tennessee
ComponentRVULocality factorAdjusted
Physician work21.27× 1.00021.2700
Practice expense3.32× 0.9093.0179
Malpractice5.43× 0.5372.9159
Total RVUs27.2038
Conversion factor× 33.4009

Facility rate, Tennessee$908.63

Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work21.271
Practice expense3.320.909
Malpractice5.430.537

(21.27 × 1 + 3.32 × 0.909 + 5.43 × 0.537) × $33.4009 = $908.63

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

35616 billing questions

How is this code distinguished from a carotid-to-subclavian bypass?

Use this code when the bypass runs from the subclavian artery to the axillary artery. A carotid-to-subclavian route has different inflow and is reported with 35606.

Does the graft material affect code selection?

This code represents a bypass using a conduit other than vein. A bypass using vein belongs to the applicable vein-graft code, selected for its documented endpoints.

What operative details support reporting this code?

The operative report should establish the subclavian inflow, axillary outflow, bypass route, and non-vein graft used, along with the clinical reason for revascularization.

How are bilateral procedures and other same-session operations handled?

Bilateral reporting with modifier 50 is paid at 150%. When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team-surgery payment is not permitted.

What care is included in the global period?

The 90-day global period includes the day-before preoperative visit and related postoperative care during the following 90 days.

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.

RVUs for 35616PPRRVU2026_Oct_nonQPP.csv, line 4,375 (RVU26D)
Geographic factors for TennesseeGPCI2026.csv, line 95 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet