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    OpenPayerBilling CodesVein Bypass Graft ProceduresCPT cpt-35511-subclavian-artery-to-subclavian-artery-vein-bypass
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    CPT 35511: Subclavian-to-Subclavian Vein Bypass Graft

    Medicare pays $1018 on average nationally for this procedure.

    CPT code 35511 describes surgical creation of a bypass graft connecting one subclavian artery to the opposite subclavian artery using a vein graft, a vascular bypass procedure performed to circumvent arterial occlusion; service type: arterial bypass surgery (subclavian–subclavian vein grafting); typical site of service: inpatient or outpatient hospital operating room or vascular surgery center.

    For related coverage guidance, see recent payer policy updates: Automated Ambulatory Blood Pressure Monitoring for Diagnosis of Hypertension in Patients with Elevated Office Blood Pressure, Cardiology - Ivabradine, Cardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA).

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is a 65-year-old with progressive left upper extremity claudication, diminished brachial pulses, and imaging-confirmed occlusive subclavian artery disease not amenable to percutaneous angioplasty or stenting. The patient has risk factors such as hypertension, hyperlipidemia, and peripheral arterial disease. After noninvasive studies (duplex ultrasound, CT angiography) demonstrate a chronic high-grade stenosis or occlusion of one subclavian artery with inadequate collateral circulation and persistent ischemic symptoms, vascular surgery evaluates the patient for open revascularization.

    In the operating room under general anesthesia, the vascular surgeon harvests an autogenous vein graft (commonly the ipsilateral or contralateral greater saphenous vein), exposes both subclavian arteries through supraclavicular and infraclavicular approaches as needed, and constructs a bypass from one subclavian artery to the contralateral subclavian artery to restore inflow to the ischemic limb. Intraoperative monitoring includes arterial line pressure, duplex or completion angiography to verify graft patency, and anticoagulation per protocol. Postoperative care occurs in a monitored setting with vascular checks, wound care, and antiplatelet therapy. Discharge planning includes surveillance duplex imaging and risk-factor modification.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    36215Selective catheter placement, arterial system; each first order thoracic branch, internal mammary, subclavian, vertebral, or carotid artery when performed from a separate catheter positionDiagnostic or adjunctive angiography to map lesion anatomy pre- or intraoperatively.
    35476Thromboendarterectomy, subclavian artery, with or without patch angioplastyAlternative open revascularization when lesion is amenable to endarterectomy rather than bypass.
    35566Extra-anatomic bypass, axillo-brachial or axillo-axillary using prosthetic graft (includes harvesting if performed)Related extra-anatomic bypass options; may be chosen instead of contralateral subclavian-to-subclavian bypass depending on anatomy.
    93567Transcatheter placement of other vascular device (Not typical)Data not available in the input. When endovascular adjuncts are used — excluded per input rules.
    93925Duplex scan of extremity arteries, unilateral or bilateral studyPreoperative and postoperative surveillance imaging to assess graft patency.
    99160Anesthesia preoperative evaluation and managementAnesthesia services that support operative care for patients undergoing open bypass procedures.

    Related Modifiers

    12 rows

    ModifierDescriptionWhen to Use
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    51Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…

    Showing 1–10 of 12

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207K00000X
    208100000X
    207L00000X
    261QS1000X
    163WA2000X
    207XS0106X
    2085R0203X
    163WS0121X

    Related ICD-10-CM Codes

    29 rows

    ICD-10-CM CodeDescription
    E11.51Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene
    E11.9Type 2 diabetes mellitus without complications
    E78.5Hyperlipidemia, unspecified
    G45.8Other transient cerebral ischemic attacks and related syndromes
    G45.9Transient cerebral ischemic attack, unspecified
    I25.10Atherosclerotic heart disease of native coronary artery without angina pectoris
    I25.110Atherosclerotic heart disease of native coronary artery with unstable angina pectoris
    I25.9Chronic ischemic heart disease, unspecified
    I51.9Heart disease, unspecified
    I65.21Occlusion and stenosis of right carotid artery

    Showing 1–10 of 29

    Related Payer Policy Updates

    Specialty: Cardiology1 / 2

    10 rows

    PolicyPayerEffective Date
    Automated Ambulatory Blood Pressure Monitoring for Diagnosis of Hypertension in Patients with Elevated Office Blood PressureBluecross Idaho2026-11-01
    Cardiology - IvabradineCigna2026-10-15
    Cardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA)univerahealthcare2026-10-15
    Percutaneous Ventricular Assist DeviceUnitedHealthcare2026-10-01
    Cardiovascular Disease Risk AssessmentOscar Health2026-10-01
    Biomarkers for Myocardial Infarction and Chronic Heart FailureOscar Health2026-10-01
    Multiple Procedure Payment Reduction for Diagnostic Cardiovascular ProceduresBlue Cross Blue Shield - Maine2026-10-01
    Left Atrial Appendage Closure Devicesexcellus_health_plan_inc2026-09-17
    Left Atrial Appendage Closure Devicesuniverahealthcare2026-09-17
    Cardiac Omnibus CodesCigna2026-09-15

    Related Codes

    CPT-35500-ARM-VEIN-HARVEST-FOR-BYPASS-CONDUIT

    CPT 35500: Upper Extremity Vein Harvest for Bypass Conduit

    CPT-35501-CAROTID-COMMON-TO-INTERNAL-ARTERY-BYPASS-GRAFT

    CPT 35501: Carotid Bypass, Common to Internal Carotid Artery

    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 Vein Bypass Graft

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

    CPT 35510: Carotid-to-Brachial Vein Bypass Graft

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

    CPT 35512: Subclavian-to-Brachial Artery Bypass with Vein Graft

    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 Graft

    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

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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