Billing code 35616: Arterial bypassMedicare rate & RVUs in Texas
Reports open revascularization using a non-vein graft to route blood from the subclavian artery to the axillary artery around an obstructed segment.
CMS doesn’t publish an office rate for 35616 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 35616 covers
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.
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 35616 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 | $989.87 |
| Beaumont | Unavailable | $979.84 |
| Brazoria | Unavailable | $967.48 |
| Dallas | Unavailable | $982.89 |
| Fort Worth | Unavailable | $984.14 |
| Galveston | Unavailable | $976.41 |
| Houston | Unavailable | $1,075.80 |
| Rest Of Texas | Unavailable | $979.45 |
How the 35616 rate is calculated
Each of 35616’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 · 35616
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 21.27Practice expense 3.32Malpractice 5.43
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 35616
35616 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 35616
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 · 35616
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
35616 without 50 · national facility
$1,002.70
Arterial bypass
35616-50 · Bilateral: 150%
$1,504.05
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).
35616 compared with similar codes
Compare codes
35616 vs 35606 vs 35612 vs 35650 vs 35621: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 35606Arterial bypass
- This code uses subclavian inflow and axillary outflow. Code 35606 describes a bypass from the carotid artery to the subclavian artery.
- 35612Arterial bypass
- This code ends at the axillary artery. Code 35612 connects one subclavian artery to the other.
- 35650Arterial bypass
- This code runs from the subclavian artery to the axillary artery. Code 35650 uses one axillary artery as inflow and the other as outflow.
- 35621Arterial bypass
- This code has axillary outflow. Code 35621 carries blood from the axillary artery to the femoral artery.
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 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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