Find policies, billing codes, payers, states, and providers

CPT 35501: Carotid Common-to-Internal Artery Bypass Graft

CPT code 35501 denotes an open vascular procedure to bypass a blockage by grafting the common carotid artery to the internal carotid artery on the same side of the neck. The code captures a technically complex revascularization procedure used to restore cerebral blood flow when intracranial or extracranial carotid lesions are not amenable to endarterectomy or endovascular repair. Nationally, this code is relevant for vascular surgery programs, hospital surgical departments, and payers managing high-acuity cerebrovascular interventions.

Key payers considered in national coverage and payment discussions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context for the procedure, typical sites of service, and the scope of application for carotid bypass grafting. The publication also summarizes typical billing considerations and common modifiers when available, and highlights what institutions and payers generally consider when evaluating claims for complex carotid revascularization.

This guide is intended to give a concise operational and clinical overview of CPT code 35501, help stakeholders recognize when the code applies, and outline the kinds of benchmarks, policy topics, and clinical contexts that commonly influence coverage and utilization nationally.

Customize your policy alerts

Sign up for cpt 35501 policy alerts

Get alerted when payer policies referencing 35501 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Billing Code Overview

CPT code 35501 describes a surgical procedure in which a provider bypasses a blockage in a carotid blood vessel by placing a bypass graft that connects the common carotid artery to a portion of the internal carotid artery on the same side of the neck. This is a vascular surgical procedure addressing carotid artery occlusive disease.

Service type: Open vascular bypass surgery involving arterial graft placement
Typical site of service: Hospital operating room or specialized vascular surgery suite

Data not available in the input.

Find policies, billing codes, payers, states, and providers

CPT 35501: Carotid Common-to-Internal Artery Bypass Graft

Customize your policy alerts

Sign up for cpt 35501 policy alerts

Get alerted when payer policies referencing 35501 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Billing Code Overview

Service type: Open vascular bypass surgery involving arterial graft placement
Typical site of service: Hospital operating room or specialized vascular surgery suite

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 72-year-old male with symptomatic, high-grade internal carotid artery (ICA) stenosis presents with crescendo transient ischemic attacks (TIAs) affecting the right cerebral hemisphere. Noninvasive vascular imaging (carotid duplex ultrasound and CT angiography) confirms an occlusive plaque at the proximal right ICA with inadequate distal runoff and a high risk of stroke. After multidisciplinary review, the vascular surgeon elects to perform a carotid bypass: creation of a graft connecting the right common carotid artery to a patent segment of the right internal carotid artery to restore antegrade flow and prevent further ischemic events.

Preoperative workflow includes neurological assessment, cross-sectional vascular imaging, cardiac risk evaluation, antiplatelet management, and informed consent discussing procedural risks (stroke, cranial nerve injury, graft occlusion). Intraoperative workflow involves general anesthesia, cervical exposure, heparinization, harvesting or selection of conduit (e.g., prosthetic or autologous vein), proximal and distal anastomoses between the common carotid artery and internal carotid artery, completion angiography or duplex to confirm flow, and postoperative monitoring in a PACU or ICU with neurologic checks and blood pressure control. Discharge planning includes antiplatelet therapy and vascular follow-up.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier (default)	Use when no modifier applies and the claim reflects standard services.
`52`	Reduced services	Use when the bypass procedure is partially reduced or not completed as originally planned.
`53`	Discontinued procedure	Use when the procedure is started but halted for patient safety before completion.
`62`	Two surgeons	Use when two surgeons with different specialties work together as primary surgeons.
`76`	Repeat procedure by same physician	Use when the same surgeon repeats the bypass procedure during the postoperative period.
`77`	Repeat procedure by another physician	Use when a different surgeon repeats the procedure during the postoperative period.
`78`	Unplanned return to OR for related procedure during global period	Use when the patient returns to the OR emergently for a complication of the bypass (e.g., graft revision) within the global period.
`79`	Unrelated procedure or service during global period	Use when an unrelated surgical procedure is performed during the global period.
`80`	Assistant surgeon	Use when a qualified assistant surgeon provides significant intraoperative assistance.
`LT`	Left side	Use when the bypass is performed on the left carotid circulation.
`RT`	Right side	Use when the bypass is performed on the right carotid circulation.
`22`	Increased procedural services	Use when work or complexity substantially exceeds that usually required (e.g., hostile neck, reoperative field).
`23`	Unusual anesthesia	Use when general anesthesia is medically contraindicated and an unusual form of anesthesia is required or when anesthesia is provided under unusual circumstances.

Taxonomy Code	Specialty	Notes
2080S0103X	Vascular Surgery	Primary specialty performing extracranial carotid bypass procedures.
207L00000X	Cardiothoracic Surgery	May perform carotid bypass in conjunction with thoracic procedures or complex cerebrovascular reconstructions.
207P00000X	General Surgery	Vascular-trained general surgeons perform open carotid bypass in select centers.
2086S0100X	Neurosurgery	May be involved for complex cerebrovascular anatomy or stroke-focused teams.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I65.21`	Occlusion and stenosis of right carotid artery	High-grade stenosis or occlusion of the internal carotid artery prompting bypass to restore cerebral perfusion.
`I65.22`	Occlusion and stenosis of left carotid artery	Left-sided disease when bypass is indicated to prevent ischemic stroke.
`G45.9`	Transient cerebral ischemic attack, unspecified	TIAs are common presenting symptoms that lead to consideration of carotid revascularization.
`I63.9`	Cerebral infarction, unspecified	Prior ischemic stroke with residual severe carotid disease may prompt bypass if other options are unsuitable.
`I66.9`	Occlusion and stenosis of unspecified cerebral artery	Complex cerebrovascular disease requiring extracranial-intracranial revascularization strategies including carotid bypass.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`35721`	Carotid-subclavian bypass, with vein and prosthetic grafts, when performed	May be performed in the same operative setting when proximal inflow requires augmentation or when multilevel supra-aortic revascularization is needed.
`35301`	Carotid endarterectomy, with or without patch graft	Often an alternative to bypass; may be performed on the contralateral side or when plaque is localized and amenable to endarterectomy.
`75962`	Intra-arterial vascular imaging, radiological supervision and interpretation	Used intraoperatively or immediately postoperatively to confirm graft patency and distal flow.
`93010`	Electrocardiogram, routine EKG with interpretation	Performed preoperatively for cardiac risk assessment prior to carotid bypass.
`93799`	Unlisted cardiovascular service or procedure	Used when a specific vascular imaging or monitoring procedure related to carotid bypass has no established code; billed with documentation.

CPT 35500: Upper-Extremity Vein Harvest for Bypass Conduit

CPT-35506-CAROTID-TO-SUBCLAVIAN-BYPASS-GRAFT

CPT 35506: Carotid-to-Subclavian Bypass Graft

CPT-35508-CAROTID-TO-VERTEBRAL-BYPASS-GRAFT

CPT 35508: Carotid-to-Vertebral Artery Bypass Graft

CPT-35509-CAROTID-TO-CAROTID-VEIN-BYPASS-GRAFT

CPT 35509: Carotid-to-Carotid Bypass with Vein Graft

CPT-35510-CAROTID-TO-BRACHIAL-ARTERY-BYPASS-VEIN-GRAFT

CPT 35510: Carotid-to-Brachial Artery Bypass with Vein Graft

CPT-35511-SUBCLAVIAN-ARTERY-TO-SUBCLAVIAN-ARTERY-VEIN-BYPASS

CPT 35511: Subclavian-to-Subclavian Vein Bypass Graft

CPT-35512-SUBCLAVIAN-TO-BRACHIAL-ARTERY-VEIN-BYPASS

CPT 35512: Subclavian-to-Brachial Artery Vein Bypass

CPT-35515-SUBCLAVIAN-TO-VERTEBRAL-ARTERY-BYPASS-VEIN-GRAFT

CPT 35515: Subclavian-to-Vertebral Artery Bypass with Vein Graft

CPT-35516-SUBCLAVIAN-TO-AXILLARY-VEIN-BYPASS

CPT 35516: Subclavian-to-Axillary Vein Bypass

CPT-35518-AXILLARY-ARTERY-TO-AXILLARY-ARTERY-BYPASS-VEIN-GRAFT

CPT 35518: Axillary-to-Axillary Artery Bypass with Vein Graft

Showing 1–10 of 32

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier (default)	Use when no modifier applies and the claim reflects standard services.
`52`	Reduced services	Use when the bypass procedure is partially reduced or not completed as originally planned.
`53`	Discontinued procedure	Use when the procedure is started but halted for patient safety before completion.
`62`	Two surgeons	Use when two surgeons with different specialties work together as primary surgeons.
`76`	Repeat procedure by same physician	Use when the same surgeon repeats the bypass procedure during the postoperative period.
`77`	Repeat procedure by another physician	Use when a different surgeon repeats the procedure during the postoperative period.
`78`	Unplanned return to OR for related procedure during global period	Use when the patient returns to the OR emergently for a complication of the bypass (e.g., graft revision) within the global period.
`79`	Unrelated procedure or service during global period	Use when an unrelated surgical procedure is performed during the global period.
`80`	Assistant surgeon	Use when a qualified assistant surgeon provides significant intraoperative assistance.
`LT`	Left side	Use when the bypass is performed on the left carotid circulation.
`RT`	Right side	Use when the bypass is performed on the right carotid circulation.
`22`	Increased procedural services	Use when work or complexity substantially exceeds that usually required (e.g., hostile neck, reoperative field).
`23`	Unusual anesthesia	Use when general anesthesia is medically contraindicated and an unusual form of anesthesia is required or when anesthesia is provided under unusual circumstances.

Taxonomy Code	Specialty	Notes
2080S0103X	Vascular Surgery	Primary specialty performing extracranial carotid bypass procedures.
207L00000X	Cardiothoracic Surgery	May perform carotid bypass in conjunction with thoracic procedures or complex cerebrovascular reconstructions.
207P00000X	General Surgery	Vascular-trained general surgeons perform open carotid bypass in select centers.
2086S0100X	Neurosurgery	May be involved for complex cerebrovascular anatomy or stroke-focused teams.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I65.21`	Occlusion and stenosis of right carotid artery	High-grade stenosis or occlusion of the internal carotid artery prompting bypass to restore cerebral perfusion.
`I65.22`	Occlusion and stenosis of left carotid artery	Left-sided disease when bypass is indicated to prevent ischemic stroke.
`G45.9`	Transient cerebral ischemic attack, unspecified	TIAs are common presenting symptoms that lead to consideration of carotid revascularization.
`I63.9`	Cerebral infarction, unspecified	Prior ischemic stroke with residual severe carotid disease may prompt bypass if other options are unsuitable.
`I66.9`	Occlusion and stenosis of unspecified cerebral artery	Complex cerebrovascular disease requiring extracranial-intracranial revascularization strategies including carotid bypass.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`35721`	Carotid-subclavian bypass, with vein and prosthetic grafts, when performed	May be performed in the same operative setting when proximal inflow requires augmentation or when multilevel supra-aortic revascularization is needed.
`35301`	Carotid endarterectomy, with or without patch graft	Often an alternative to bypass; may be performed on the contralateral side or when plaque is localized and amenable to endarterectomy.
`75962`	Intra-arterial vascular imaging, radiological supervision and interpretation	Used intraoperatively or immediately postoperatively to confirm graft patency and distal flow.
`93010`	Electrocardiogram, routine EKG with interpretation	Performed preoperatively for cardiac risk assessment prior to carotid bypass.
`93799`	Unlisted cardiovascular service or procedure	Used when a specific vascular imaging or monitoring procedure related to carotid bypass has no established code; billed with documentation.

CPT 35500: Upper-Extremity Vein Harvest for Bypass Conduit

CPT-35506-CAROTID-TO-SUBCLAVIAN-BYPASS-GRAFT

CPT 35506: Carotid-to-Subclavian Bypass Graft

CPT-35508-CAROTID-TO-VERTEBRAL-BYPASS-GRAFT

CPT 35508: Carotid-to-Vertebral Artery Bypass Graft

CPT-35509-CAROTID-TO-CAROTID-VEIN-BYPASS-GRAFT

CPT 35509: Carotid-to-Carotid Bypass with Vein Graft

CPT-35510-CAROTID-TO-BRACHIAL-ARTERY-BYPASS-VEIN-GRAFT

CPT 35510: Carotid-to-Brachial Artery Bypass with Vein Graft

CPT-35511-SUBCLAVIAN-ARTERY-TO-SUBCLAVIAN-ARTERY-VEIN-BYPASS

CPT 35511: Subclavian-to-Subclavian Vein Bypass Graft

CPT-35512-SUBCLAVIAN-TO-BRACHIAL-ARTERY-VEIN-BYPASS

CPT 35512: Subclavian-to-Brachial Artery Vein Bypass

CPT-35515-SUBCLAVIAN-TO-VERTEBRAL-ARTERY-BYPASS-VEIN-GRAFT

CPT 35515: Subclavian-to-Vertebral Artery Bypass with Vein Graft

CPT-35516-SUBCLAVIAN-TO-AXILLARY-VEIN-BYPASS

CPT 35516: Subclavian-to-Axillary Vein Bypass

CPT-35518-AXILLARY-ARTERY-TO-AXILLARY-ARTERY-BYPASS-VEIN-GRAFT

CPT 35518: Axillary-to-Axillary Artery Bypass with Vein Graft

Showing 1–10 of 32

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

CPT 35501: Carotid Common-to-Internal Artery Bypass Graft

Sign up for cpt 35501 policy alerts

Billing Code Overview

Catch payer policy changes before they impact reimbursement

Catch payer policy changes before they impact reimbursement

OpenPayer

CPT 35501: Carotid Common-to-Internal Artery Bypass Graft

Sign up for cpt 35501 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References