Billing code 35515: Arterial bypassMedicare rate & RVUs in Texas
Reports an open bypass routing blood from the subclavian artery to a vertebral artery to address compromised vertebral circulation.
CMS doesn’t publish an office rate for 35515 in Texas.
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 35515 covers
Code 35515 represents an open bypass that routes arterial blood from the subclavian artery to a vertebral artery, creating an alternate pathway around an obstructed or inadequate segment. Vascular surgeons perform it in the operating room for selected patients with compromised vertebral circulation, including cases associated with subclavian steal physiology. The defining feature is the named inflow and outflow vessels, not simply treatment of arm ischemia or any operation near the neck.
Report this code when operative documentation supports the subclavian-to-vertebral bypass; distinguish it from bypasses whose outflow is the carotid, axillary, or another vessel. Document laterality, anastomotic endpoints, indication, and the bypass performed. The 90-day global includes the day-before preoperative visit and related postoperative care through day 90. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others at 50%. For bilateral work, modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons are paid only with 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 35515 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $1,196.49 |
| Beaumont | Unavailable | $1,182.71 |
| Brazoria | Unavailable | $1,168.92 |
| Dallas | Unavailable | $1,187.40 |
| Fort Worth | Unavailable | $1,188.78 |
| Galveston | Unavailable | $1,179.62 |
| Houston | Unavailable | $1,298.41 |
| Rest Of Texas | Unavailable | $1,182.71 |
How the 35515 rate is calculated
Each of 35515’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 · 35515
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 25.44Practice expense 4.33Malpractice 6.49
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 35515
35515 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 35515
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 · 35515
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
35515 without 50 · national facility
$1,211.12
Arterial bypass
35515-50 · Bilateral: 150%
$1,816.68
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).
35515 compared with similar codes
Compare codes
35515 vs 35508 vs 35506 vs 35516: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 35508Arterial bypass
- Use 35515 for subclavian inflow to vertebral outflow. Use 35508 when the carotid artery is the inflow and the vertebral artery is the outflow.
- 35506Arterial bypass
- Use 35515 when the bypass ends at a vertebral artery; 35506 describes a subclavian-to-carotid bypass.
- 35516Arterial bypass
- Use 35515 for vertebral outflow. 35516 is for a bypass from the subclavian artery to the axillary artery.
35515 billing questions
How do I distinguish 35515 from a carotid-to-vertebral bypass?
Choose 35515 when the bypass runs from the subclavian artery to the vertebral artery. A carotid-to-vertebral bypass has a different inflow vessel and is represented by 35508.
Which operative details support reporting 35515?
The operative report should identify the subclavian inflow, vertebral outflow, laterality, and the bypass performed. The named vessel endpoints distinguish this service from nearby bypass procedures.
How does the 90-day global affect postoperative reporting?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
How is 35515 handled when other procedures occur in the same session?
The highest-valued procedure is paid in full, and other procedures are paid at 50%. For bilateral work, modifier 50 is paid at 150%.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only when supporting documentation is provided; 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
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