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    OpenPayerBilling CodesVein Bypass Graft ProceduresCPT cpt-35516-subclavian-to-axillary-vein-bypass
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    CPT 35516: Subclavian to Axillary Vein Bypass Graft

    Medicare pays $1108 on average nationally for this procedure.

    CPT code 35516 describes a surgical bypass procedure in which the provider creates a graft using a vein to connect the subclavian artery to a portion of the axillary artery to circumvent an arterial obstruction; this is an open vascular surgical service typically performed in an operating room or vascular surgery suite and involves vessel exposure, creation and anastomosis of a bypass graft for upper extremity or thoracic outlet revascularization.

    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 68-year-old male with a history of peripheral artery disease and symptomatic left upper extremity ischemia presents with progressive arm claudication, resting pain, and diminished radial pulse. Noninvasive vascular testing and CT angiography demonstrate a high-grade occlusion of the proximal left subclavian artery proximal to the vertebral origin. After multidisciplinary vascular surgery and vascular medicine evaluation, the patient is scheduled for an open subclavian-to-axillary bypass using an autogenous vein graft because endovascular options are unsuitable due to long-segment occlusion and vessel tortuosity.

    Preoperative workflow includes pre-anesthesia evaluation, consent for open bypass, venous mapping for conduit harvest, and perioperative antibiotics. Intraoperative steps include general anesthesia, exposure of the subclavian artery and axillary artery via supraclavicular and infraclavicular incisions as needed, harvest of ipsilateral greater saphenous or arm vein, systemic heparinization, creation of proximal anastomosis to the subclavian artery, tunneling of the vein graft, distal anastomosis to the axillary artery, flow assessment, and hemostasis. Postoperative care includes vascular monitoring of pulses and limb perfusion, wound care, antiplatelet therapy, and duplex ultrasound surveillance prior to discharge.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    35516Bypass graft to establish flow from subclavian artery to axillary artery using vein graft (as described)Primary procedure — open surgical arterial bypass connecting subclavian to axillary artery using autogenous vein graft
    35631Bypass graft, with vein; axillary-femoral or femoral-axillary (extra-anatomic)Alternative or adjunct bypass options in patients needing extra-anatomic flow restoration; may be considered when thoracic outlet bypass is not feasible
    35556Revision or repair of bypass graft; extra-anatomic or other upper extremity graft revisionUsed for graft revisions, thrombectomy, or repair if the initial 35516 graft requires re-intervention
    36215Selective catheter placement, arterial, radiological supervision and interpretationMay be performed preoperatively for diagnostic angiography or intraoperatively for angiographic assessment of inflow/outflow
    93925Duple x ultrasound arterial physiology, complete bilateral or unilateral studyPreoperative and postoperative noninvasive surveillance of upper extremity arterial flow and graft patency

    Related Modifiers

    8 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…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    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…
    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…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207R00000X
    207P00000X
    207T00000X
    1835I0206X
    207SG0202X
    2278P1006X
    261QE0700X
    224ZE0001X

    Related ICD-10-CM Codes

    25 rows

    ICD-10-CM CodeDescription
    E78.5Hyperlipidemia, unspecified
    G45.9Transient cerebral ischemic attack, unspecified
    I70.219Atherosclerosis of native arteries of extremities with intermittent claudication, unspecified extremity
    I70.221Atherosclerosis of native arteries of extremities with rest pain, right leg
    I70.229Atherosclerosis of native arteries of extremities with rest pain, unspecified extremity
    I70.231Atherosclerosis of native arteries of right leg with ulceration of thigh
    I70.232Atherosclerosis of native arteries of right leg with ulceration of calf
    I70.233Atherosclerosis of native arteries of right leg with ulceration of ankle
    I70.238Atherosclerosis of native arteries of right leg with ulceration of other part of lower leg
    I70.239Atherosclerosis of native arteries of right leg with ulceration of unspecified site

    Showing 1–10 of 25

    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-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 Bypass with Vein Graft

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

    CPT 35515: Subclavian to Vertebral Artery Bypass with Vein 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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