Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 35516 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Bypass Graft W Vein; Subclavian-Axillary
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Cardiovascular System |
| Common Place of Service | 21 - Inpatient Hospital |
| Common Modifiers | RT - Right side of body LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | $1,109.91 national non-facility rate (2026) · View Medicare rates for 35516 |
| Medicaid Fee Schedule | $928.94 median of the 8 states in the free preview · View Medicaid rates for 35516 |
National average reimbursement for CPT 35516 by major payers:
$1,613.22
$1,675.07
$1,752.14
$1,965.61
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 35516.
CPT 35516
5 of 25 sample ratesHigher to lower in this preview
Carolina Regional Surgery Center. Ltd
Carolina Regional Surgery Center Ltd
$2,575.00Published rateAdvanced Center For Surgery, The Advanced Center For Surgery
Advanced Center For Surgery
$1,049.00Published rateThe Endoscopy Center At Bainbridge, LLC, University Suburban Endoscopy Center
The Endoscopy Center At Bainbridge LLC
$853.00Published rateSurgery Center On 27 LLC
$552.00Published rateEndosurg Outpatient Center LLC
$225.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 35516 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 35516 code is part of the Surgery services used for Surgical Procedures on the Cardiovascular System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 35516 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 35511-CPT | High | Bypass Graft W Vein; Subclavian-Subclavi |
| 35512-CPT | High | Bypass Graft, With Vein; Subclavian-Brachial |
| 35516-CPT | High | Bypass Graft W Vein; Subclavian-Axillary |
| 35606-CPT | High | Artery Bypass With Graft, Surgery To Bypass (Re-Route) Blood Flow Around A Blocked Artery Using A Synthetic Material (Graft) To Replace The Diseased Artery. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 35516. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 35516 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 35516) and we'll show you how you compare in 15 minutes or less.