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CPT 35512: Subclavian-to-Brachial Artery Vein Bypass

CPT code 35512 represents an open vascular bypass where a vein graft connects the subclavian artery to a segment of the brachial artery to circumvent an occlusive lesion and reestablish arterial flow to the arm. This surgical revascularization procedure matters nationally as a treatment for critical limb ischemia of the upper extremity and for preserving limb function when endovascular options are unsuitable.

Payers commonly involved in coverage and reimbursement for this procedure include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context about the procedure, typical sites of service, and the kinds of operational and billing considerations associated with an open upper extremity arterial bypass. The publication outlines benchmarks and reimbursement patterns where available, summarizes relevant coding relationships, and highlights areas of policy or coverage nuance that affect payment and utilization. Clinical implications, including indications for surgical bypass versus endovascular therapy and expected care settings, are described to inform coding, billing, and administrative decision-making for national audiences.

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Billing Code Overview

CPT code 35512 describes a surgical arterial bypass procedure in which the provider creates a bypass graft connecting the subclavian artery to a portion of the brachial artery using a vein graft to bypass an obstructed vessel. This procedure is performed to restore arterial blood flow to the upper extremity when native arterial circulation is compromised by occlusion or severe stenosis.

Service type: Surgical arterial bypass (upper extremity vascular bypass)
Typical site of service: Inpatient or outpatient surgical setting, commonly performed in an operating room with vascular surgery capabilities

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CPT 35512: Subclavian-to-Brachial Artery Vein Bypass

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Get alerted when payer policies referencing 35512 are released or updated.

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Billing Code Overview

Service type: Surgical arterial bypass (upper extremity vascular bypass)
Typical site of service: Inpatient or outpatient surgical setting, commonly performed in an operating room with vascular surgery capabilities

Clinical & Coding Specifications

Clinical Context

A 68-year-old male with a history of peripheral arterial disease and progressive ischemic symptoms of the right upper extremity presents with rest pain, digital ischemia, and nonhealing fingertip ulcers despite optimal medical therapy and endovascular attempts. Diagnostic imaging (duplex ultrasound and angiography) demonstrates a high-grade occlusive lesion of the right subclavian artery proximal to the vertebral takeoff with inadequate inflow to the brachial artery. The vascular surgery team decides to perform an open extra-anatomic bypass: creation of a subclavian-to-brachial artery bypass using an autologous vein graft to restore distal perfusion.

Preoperative workflow includes cardiopulmonary assessment, informed consent documenting the bypass and graft source, and marking of the vein harvest site. Intraoperative steps include exposure of the subclavian artery, harvest and preparation of the vein graft (typically ipsilateral or contralateral greater saphenous or upper extremity vein), tunneling of the graft to the brachial artery, proximal and distal anastomoses, hemostasis, and assessment of flow (palpable pulses, Doppler signals). Postoperative management includes monitoring for graft patency, anticoagulation or antiplatelet therapy per institutional protocol, wound care, and surveillance duplex imaging during follow-up.

Coding Specifications

Modifier	Description	When to Use
`00`	Modifier not recognized for Medicare/other payors (placeholder standard)	Not typically appended; use per payer directive if required.
`11`	Office/clinic not applicable to surgical CPT (typically main procedure)	Not used as a modifier for operative reporting; included in lists per payer systems.
`22`	Increased procedural services	Use when work or resources substantially exceed typical effort for `35512` (needs documentation).
`26`	Professional component	Use if billing only the physician professional component separate from facility (rare for bypass surgery).
`50`	Bilateral procedure	Use if identical bypass performed on both upper extremities during same operative session (rare).
`62`	Two surgeons	Use when two surgeons of different specialties work together as primary surgeons during the same operative session.
`66`	Surgical team (multiple surgeons)	Use when service is furnished by a surgical team per payer policy.
`78`	Unplanned return to OR for related procedure during global period	Use for a return to the operating room related to the original `35512` within the postoperative global period.
`80`	Assistant surgeon	Use when an assistant surgeon (non-scrubbed primary) performs designated assisting tasks and billing supports assistant surgeon payment.
`81`	Minimum assistant surgeon	Use when a physician provides limited assisting services and payer recognizes `81`.
`82`	Assistant surgeon when qualified resident unavailable	Use when a qualified resident is unavailable and an assistant surgeon is required.
`53`	Discontinued procedure	Use when `35512` is started but discontinued due to extenuating circumstances; document reason.
`76`	Repeat procedure by same physician	Use when the same physician repeats the procedure later on same day (if clinically applicable).
`78`	(duplicate entry avoided)

Taxonomy Code	Specialty	Notes
207L00000X	Vascular Surgery	Primary specialty performing open subclavian-to-brachial bypass.
207SG0200X	Thoracic and Cardiac Surgery	May perform supra-aortic and subclavian reconstructions in some centers.
207P00000X	General Surgery	Vascular-trained general surgeons perform peripheral bypass procedures.
2080P0207X	Interventional Cardiology	Typically performs endovascular alternatives; may be part of hybrid procedures.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I70.219`	Atherosclerosis of native arteries of the extremities, right leg unspecified	Atherosclerotic occlusive disease is a common cause of subclavian and brachial inflow compromise necessitating bypass.
`I70.229`	Atherosclerosis of native arteries of the extremities, left leg unspecified	Contralateral disease may be present; systemic atherosclerosis context.
`I74.3`	Embolism and thrombosis of arteries of upper extremities	Acute embolic occlusion may mandate bypass or thrombectomy in addition to revascularization.
`I73.9`	Peripheral vascular disease, unspecified	Broad code capturing chronic limb ischemia indications for upper extremity revascularization.
`G45.9`	Transient cerebral ischemic attack, unspecified	Subclavian stenosis proximal to vertebral artery can contribute to vertebrobasilar insufficiency in some patients (consideration in surgical planning).

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`35512`	Bypass graft, with vein; subclavian to brachial	Primary procedure restoring arterial inflow to the upper extremity by vein graft (subject code).
`35631`	Bypass graft, venae comitantes or other, upper extremity; brachial to radial or ulnar artery	Performed when distal bypass extension or additional distal revascularization is required.
`35600`	Thrombectomy or embolectomy, with or without arteriotomy; upper extremity	Performed if intraoperative thrombosis or embolus requires removal to salvage graft or native artery.
`36147`	Introduction of catheter into artery, other than central (e.g., diagnostic angiography of limb)	Preoperative or intraoperative angiography or access procedures for localization and planning.
`37799`	Unlisted procedure, vascular surgery	Used for unusual or adjunct vascular procedures not described by specific CPT codes during the same operative session.
`93925`	Duplex scan of upper extremity arterial/venous mapping and postoperative surveillance	Used preoperatively for mapping vessels or postoperatively to assess graft patency.

CPT 35500: Upper-Extremity Vein Harvest for Bypass Conduit

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

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

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-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

Frequently Asked Questions

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`	Modifier not recognized for Medicare/other payors (placeholder standard)	Not typically appended; use per payer directive if required.
`11`	Office/clinic not applicable to surgical CPT (typically main procedure)	Not used as a modifier for operative reporting; included in lists per payer systems.
`22`	Increased procedural services	Use when work or resources substantially exceed typical effort for `35512` (needs documentation).
`26`	Professional component	Use if billing only the physician professional component separate from facility (rare for bypass surgery).
`50`	Bilateral procedure	Use if identical bypass performed on both upper extremities during same operative session (rare).
`62`	Two surgeons	Use when two surgeons of different specialties work together as primary surgeons during the same operative session.
`66`	Surgical team (multiple surgeons)	Use when service is furnished by a surgical team per payer policy.
`78`	Unplanned return to OR for related procedure during global period	Use for a return to the operating room related to the original `35512` within the postoperative global period.
`80`	Assistant surgeon	Use when an assistant surgeon (non-scrubbed primary) performs designated assisting tasks and billing supports assistant surgeon payment.
`81`	Minimum assistant surgeon	Use when a physician provides limited assisting services and payer recognizes `81`.
`82`	Assistant surgeon when qualified resident unavailable	Use when a qualified resident is unavailable and an assistant surgeon is required.
`53`	Discontinued procedure	Use when `35512` is started but discontinued due to extenuating circumstances; document reason.
`76`	Repeat procedure by same physician	Use when the same physician repeats the procedure later on same day (if clinically applicable).
`78`	(duplicate entry avoided)

Taxonomy Code	Specialty	Notes
207L00000X	Vascular Surgery	Primary specialty performing open subclavian-to-brachial bypass.
207SG0200X	Thoracic and Cardiac Surgery	May perform supra-aortic and subclavian reconstructions in some centers.
207P00000X	General Surgery	Vascular-trained general surgeons perform peripheral bypass procedures.
2080P0207X	Interventional Cardiology	Typically performs endovascular alternatives; may be part of hybrid procedures.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I70.219`	Atherosclerosis of native arteries of the extremities, right leg unspecified	Atherosclerotic occlusive disease is a common cause of subclavian and brachial inflow compromise necessitating bypass.
`I70.229`	Atherosclerosis of native arteries of the extremities, left leg unspecified	Contralateral disease may be present; systemic atherosclerosis context.
`I74.3`	Embolism and thrombosis of arteries of upper extremities	Acute embolic occlusion may mandate bypass or thrombectomy in addition to revascularization.
`I73.9`	Peripheral vascular disease, unspecified	Broad code capturing chronic limb ischemia indications for upper extremity revascularization.
`G45.9`	Transient cerebral ischemic attack, unspecified	Subclavian stenosis proximal to vertebral artery can contribute to vertebrobasilar insufficiency in some patients (consideration in surgical planning).

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`35512`	Bypass graft, with vein; subclavian to brachial	Primary procedure restoring arterial inflow to the upper extremity by vein graft (subject code).
`35631`	Bypass graft, venae comitantes or other, upper extremity; brachial to radial or ulnar artery	Performed when distal bypass extension or additional distal revascularization is required.
`35600`	Thrombectomy or embolectomy, with or without arteriotomy; upper extremity	Performed if intraoperative thrombosis or embolus requires removal to salvage graft or native artery.
`36147`	Introduction of catheter into artery, other than central (e.g., diagnostic angiography of limb)	Preoperative or intraoperative angiography or access procedures for localization and planning.
`37799`	Unlisted procedure, vascular surgery	Used for unusual or adjunct vascular procedures not described by specific CPT codes during the same operative session.
`93925`	Duplex scan of upper extremity arterial/venous mapping and postoperative surveillance	Used preoperatively for mapping vessels or postoperatively to assess graft patency.

CPT 35500: Upper-Extremity Vein Harvest for Bypass Conduit

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

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

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-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

Frequently Asked Questions

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.

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CPT 35512: Subclavian-to-Brachial Artery Vein Bypass

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Billing Code Overview

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CPT 35512: Subclavian-to-Brachial Artery Vein Bypass

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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

CPT 35512: Subclavian-to-Brachial Artery Vein Bypass

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Billing Code Overview

CPT 35512: Subclavian-to-Brachial Artery Vein Bypass

Sign up for cpt 35512 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does CPT 35512 represent and where is it typically performed?

Which specialties commonly perform or participate in a subclavian-to-brachial vein bypass?

Which CPT modifiers are relevant for billing CPT 35512 and when are they used?

What related CPT codes should be considered when billing for procedures associated with 35512?

Which payers are commonly associated with coverage for CPT 35512 and does the page provide reimbursement rates?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does CPT 35512 represent and where is it typically performed?

Which specialties commonly perform or participate in a subclavian-to-brachial vein bypass?

Which CPT modifiers are relevant for billing CPT 35512 and when are they used?

What related CPT codes should be considered when billing for procedures associated with 35512?

Which payers are commonly associated with coverage for CPT 35512 and does the page provide reimbursement rates?

References