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    v1.0.30
    OpenPayerBilling CodesBypass Graft Procedures Other Than VeinCPT cpt-35606-subclavian-artery-bypass-synthetic-graft
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    CPT 35606: Subclavian Artery Bypass with Synthetic Graft

    Medicare pays $1065 on average nationally for this procedure.

    CPT code 35606 describes a surgical bypass of a subclavian artery obstruction using a synthetic (prosthetic) graft; the service is a vascular surgical procedure performed to restore blood flow to the upper extremity or vertebrobasilar circulation and is typically provided in an inpatient hospital operating room or an outpatient hospital surgical suite depending on patient status.

    For related coverage guidance, see recent payer policy updates: Surgical Procedures, Outpatient Surgical Procedures - Site of Service, Site of Service Ambulatory Service Center (ASC) Select — Surgical or Diagnostic Procedures in Adults.

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    Table of contents

    Progress1 / 7

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is a 68-year-old man with symptomatic left arm claudication, coolness, and diminished pulses due to atherosclerotic occlusive disease of the subclavian artery. Noninvasive testing (duplex ultrasound, CT angiography) demonstrates a high-grade proximal left subclavian stenosis or occlusion not amenable to percutaneous intervention or with prior failed angioplasty. The vascular surgery team schedules an elective open bypass procedure using a synthetic graft (eg, PTFE) from the carotid or axillary artery to the distal subclavian/axillary artery to re-establish upper extremity inflow. Preoperative workflow includes vascular lab imaging, cardiopulmonary risk assessment, medication management (antiplatelet, anticoagulation review), and informed consent for potential blood loss and nerve injury. Intraoperative workflow involves general anesthesia, exposure of inflow and outflow vessels, tunneling of the synthetic graft, completion angiography or Doppler confirmation of graft patency, and hemostasis. Postoperative care includes monitoring in a surgical ward or stepdown unit for limb perfusion, graft patency checks, pain control, wound care, and planning for antiplatelet therapy and follow-up vascular imaging.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    35606Bypass graft, with other than vein; subclavian arteryPrimary procedure: synthetic graft bypass to bypass subclavian obstruction.
    34002Thromboendarterectomy, without patch, subclavian arteryAlternative or adjunct open procedure addressing atherosclerotic plaque in the subclavian artery.
    35556Endarterectomy, brachiocephalic artery, with or without patchPerformed when disease involves proximal great vessels and combined inflow procedures are necessary.
    36147Insertion of arterial sheath, radiologic; any methodUsed if intraoperative angiography or endovascular access is performed for completion imaging or hybrid repair.
    75710Angiography, extremity, unilateral, radiological supervision and interpretationCompletion angiography to confirm graft patency performed intra- or post-operatively.

    Related Modifiers

    10 rows

    ModifierDescriptionWhen to Use
    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…
    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…
    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…
    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…
    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…
    73Modifier 73 indicates a facility-level outpatient hospital or ASC procedure that was discontinued after the patient was prepared and taken to the procedure/operating room but before any anesthesia…- When to use: Apply CPT modifier 73 on the FACILITY (outpatient hospital or ASC) claim when the patient has been fully prepared and physically taken into the procedure/operating room but the…
    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…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    208D00000X
    207L00000X
    207KA0200X
    174200000X
    207XX0005X
    207K00000X
    282N00000X
    1710I1003X

    Related ICD-10-CM Codes

    24 rows

    ICD-10-CM CodeDescription
    G45.3Amaurosis fugax
    G45.8Other transient cerebral ischemic attacks and related syndromes
    G45.9Transient cerebral ischemic attack, unspecified
    I65.21Occlusion and stenosis of right carotid artery
    I65.22Occlusion and stenosis of left carotid artery
    I65.29Occlusion and stenosis of unspecified carotid artery
    I70.213Atherosclerosis of native arteries of extremities with intermittent claudication, bilateral legs
    I70.231Atherosclerosis of native arteries of right leg with ulceration of thigh
    I70.233Atherosclerosis of native arteries of right leg with ulceration of ankle
    I70.235Atherosclerosis of native arteries of right leg with ulceration of other part of foot

    Showing 1–10 of 24

    Related Payer Policy Updates

    Specialty: General Surgery1 / 2

    10 rows

    PolicyPayerEffective Date
    Surgical ProceduresUnitedHealthcare2026-09-01
    Outpatient Surgical Procedures - Site of ServiceUnitedHealthcare2026-09-01
    Site of Service Ambulatory Service Center (ASC) Select — Surgical or Diagnostic Procedures in AdultsPremera Bluecross2026-09-01
    Site of Service Ambulatory Surgical Center (ASC) Select — Surgical or Diagnostic Procedures in AdultsPremera Bluecross2026-09-01
    Site of Service Ambulatory Service Center (ASC) SelectPremera Bluecross2026-09-01
    Site of Service Ambulatory Surgical Center (ASC) Select — Site of Service for Ambulatory Surgical Procedures (ASC Select)Premera Bluecross2026-09-01
    Site of Service Ambulatory Service Center (ASC) SelectPremera Bluecross2026-09-01
    Outpatient Surgical Procedures - Site of Servicesierra health and life2026-08-01
    Medical Necessity Guidelines — Inpatient Surgical CareMass General Brigham Health Plan2026-08-01
    Ambulatory Surgery Center (ASC) - Site of Care PolicyKaiser Permanente2026-08-01

    Related Codes

    CPT-35600-ARTERIAL-GRAFT-HARVEST-ARM-FOR-CORONARY-BYPASS

    CPT 35600: Arm Artery Harvest for Coronary Bypass

    CPT-35601-CAROTID-COMMON-ARTERY-BYPASS-SYNTHETIC-GRAFT

    CPT 35601: Common Carotid Artery Bypass with Synthetic Graft

    CPT-35602-CAROTID-TO-CAROTID-PROSTHETIC-ARTERIAL-BYPASS

    CPT 35602: Carotid-to-Carotid Bypass with Prosthetic Graft

    CPT-35612-SUBCLAVIAN-ARTERY-BYPASS-SYNTHETIC-GRAFT

    CPT 35612: Subclavian Artery Bypass with Synthetic Graft

    CPT-35616-SUBCLAVIAN-TO-AXILLARY-BYPASS-SYNTHETIC-GRAFT

    CPT 35616: Subclavian to Axillary Bypass with Synthetic Graft

    CPT-35621-AXILLOFEMORAL-BYPASS-SYNTHETIC-GRAFT

    CPT 35621: Axillary–Femoral Bypass with Synthetic Graft

    CPT-35623-AXILLARY-TO-POPLITEAL-OR-TIBIAL-BYPASS-SYNTHETIC-GRAFT

    CPT 35623: Axillofemoral to Popliteal/Tibial Bypass with Synthetic Graft

    CPT-35626-AORTIC-TO-SUBCLAVIAN-INNOMINATE-CAROTID-BYPASS-GRAFT

    CPT 35626: Aortic-to-Subclavian/Innominate/Carotid Bypass with Synthetic Graft

    CPT-35631-AORTO-VISCERAL-RENAL-BYPASS-SYNTHETIC-GRAFT

    CPT 35631: Aorto-Visceral Bypass with Synthetic Graft

    CPT-35632-ILIAC-TO-CELIAC-SYNTHETIC-GRAFT-BYPASS

    CPT 35632: Iliac-to-Celiac Arterial Bypass with Synthetic Graft

    Showing 1–10 of 27

    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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