CPT code 35533: Arterial bypass, vein graft, axillary-femoral-femoral2026 Medicare rate & RVUs in Virginia
Reports an axillary-to-bilateral femoral arterial bypass using a vein graft, often to restore lower-extremity blood flow when aortic reconstruction is unsuitable.
In Virginia, Medicare pays $1,294.12 for 35533 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 35533 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 35533 covers
Code 35533 describes an extra-anatomic bypass that carries blood from an axillary artery to a femoral artery and across to the opposite femoral artery, using a vein graft. Vascular surgeons may perform this reconstruction for severe aortoiliac occlusive disease when direct aortic reconstruction is not appropriate. The operative report should establish the axillary inflow, both femoral targets, and vein conduit used.
Select this code for the complete axillary-femoral-femoral route, rather than a single axillary-femoral bypass or a femoral-femoral bypass alone. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures at 50%. When bilateral reporting with modifier 50 is appropriate, CMS pays at 150%. Assistant-at-surgery services may be paid; co-surgeons are paid only with supporting documentation, and team surgery is not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
How Virginia compares for 35533
Across 109 of 109 payment localities, the facility rate for 35533 runs from $1,191.42 in Wisconsin to $1,756.25 in Miami, FL. Virginia pays $1,294.12. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Virginia · this page$1,294.12
- Los Angeles, CA · California$1,352.94+$58.82
- Washington, DC area · District of Columbia$1,476.60+$182.48
- Miami, FL · Florida$1,756.25+$462.13
- Chicago, IL · Illinois$1,699.57+$405.45
- Manhattan, NY · New York$1,601.70+$307.58
- Alaska · Alaska$1,754.73+$460.61
Other areas in Virginia first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $1,243.45 |
| ArkansasArkansas | — | $1,228.41 |
| ArizonaArizona | — | $1,329.39 |
| Bakersfield, CACalifornia | — | $1,305.06 |
| Chico, CACalifornia | — | $1,284.95 |
| El Centro, CACalifornia | — | $1,286.19 |
| Fresno, CACalifornia | — | $1,284.95 |
| Hanford, CACalifornia | — | $1,284.95 |
| Madera, CACalifornia | — | $1,284.95 |
| Merced, CACalifornia | — | $1,284.95 |
| Modesto, CACalifornia | — | $1,284.95 |
| Napa, CACalifornia | — | $1,355.35 |
| Oxnard, CACalifornia | — | $1,329.93 |
| Redding, CACalifornia | — | $1,284.95 |
| Rest of CaliforniaCalifornia | — | $1,284.95 |
| Riverside, CACalifornia | — | $1,364.81 |
| Sacramento, CACalifornia | — | $1,313.29 |
| Salinas, CACalifornia | — | $1,307.83 |
| San Diego, CACalifornia | — | $1,313.77 |
| Marin County, CACalifornia | — | $1,387.83 |
| San Francisco, CACalifornia | — | $1,379.37 |
| San Benito County, CACalifornia | — | $1,426.29 |
| Santa Clara County, CACalifornia | — | $1,391.71 |
| San Luis Obispo, CACalifornia | — | $1,291.26 |
| Santa Cruz, CACalifornia | — | $1,306.30 |
| Santa Maria, CACalifornia | — | $1,305.93 |
| Santa Rosa, CACalifornia | — | $1,316.97 |
| Stockton, CACalifornia | — | $1,284.95 |
| Vallejo, CACalifornia | — | $1,343.16 |
| Visalia, CACalifornia | — | $1,284.95 |
| Yuba City, CACalifornia | — | $1,284.95 |
| ColoradoColorado | — | $1,336.35 |
| ConnecticutConnecticut | — | $1,452.80 |
| DelawareDelaware | — | $1,347.75 |
| Fort Lauderdale, FLFlorida | — | $1,572.74 |
| Rest of FloridaFlorida | — | $1,488.48 |
| Atlanta, GAGeorgia | — | $1,425.06 |
| Rest of GeorgiaGeorgia | — | $1,401.71 |
| Hawaii, Guam, HIHawaii | — | $1,285.10 |
| IowaIowa | — | $1,207.26 |
| IdahoIdaho | — | $1,226.90 |
| East St. Louis, ILIllinois | — | $1,610.36 |
| Rest of IllinoisIllinois | — | $1,497.11 |
| Suburban Chicago, ILIllinois | — | $1,572.65 |
| IndianaIndiana | — | $1,231.16 |
| KansasKansas | — | $1,232.27 |
| KentuckyKentucky | — | $1,332.34 |
| New Orleans, LALouisiana | — | $1,394.96 |
| Rest of LouisianaLouisiana | — | $1,342.46 |
| Metropolitan Boston, MAMassachusetts | — | $1,410.79 |
| Rest of MassachusettsMassachusetts | — | $1,342.62 |
| Baltimore area, MDMaryland | — | $1,455.04 |
| Rest of MarylandMaryland | — | $1,360.87 |
| Rest of MaineMaine | — | $1,263.98 |
| Southern Maine, MEMaine | — | $1,276.63 |
| Detroit, MIMichigan | — | $1,535.34 |
| Rest of MichiganMichigan | — | $1,389.11 |
| MinnesotaMinnesota | — | $1,198.84 |
| Metropolitan Kansas City, MOMissouri | — | $1,355.10 |
| Metropolitan St. Louis, MOMissouri | — | $1,363.23 |
| Rest of MissouriMissouri | — | $1,343.07 |
| MississippiMississippi | — | $1,284.44 |
| MontanaMontana | — | $1,369.27 |
| North CarolinaNorth Carolina | — | $1,270.12 |
| North DakotaNorth Dakota | — | $1,221.96 |
| NebraskaNebraska | — | $1,203.70 |
| New HampshireNew Hampshire | — | $1,344.68 |
| Northern New JerseyNew Jersey | — | $1,471.53 |
| Rest of New JerseyNew Jersey | — | $1,446.37 |
| New MexicoNew Mexico | — | $1,407.62 |
| NevadaNevada | — | $1,328.36 |
| NYC suburbs and Long Island, NYNew York | — | $1,673.09 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $1,479.80 |
| Queens, NYNew York | — | $1,568.80 |
| Rest of New YorkNew York | — | $1,288.53 |
| OhioOhio | — | $1,359.00 |
| OklahomaOklahoma | — | $1,298.59 |
| Portland, OROregon | — | $1,337.93 |
| Rest of OregonOregon | — | $1,295.28 |
| Metropolitan Philadelphia, PAPennsylvania | — | $1,441.35 |
| Rest of PennsylvaniaPennsylvania | — | $1,344.06 |
| Puerto RicoPuerto Rico | — | $1,367.65 |
| Rhode IslandRhode Island | — | $1,366.25 |
| South CarolinaSouth Carolina | — | $1,321.30 |
| South DakotaSouth Dakota | — | $1,204.54 |
| TennesseeTennessee | — | $1,241.22 |
| Austin, TXTexas | — | $1,351.86 |
| Beaumont, TXTexas | — | $1,338.91 |
| Brazoria, TXTexas | — | $1,321.50 |
| Dallas, TXTexas | — | $1,342.62 |
| Fort Worth, TXTexas | — | $1,344.39 |
| Galveston, TXTexas | — | $1,333.74 |
| Houston, TXTexas | — | $1,470.10 |
| Rest of TexasTexas | — | $1,338.16 |
| UtahUtah | — | $1,335.59 |
| Virgin Islands, VIUnited States Virgin Islands | — | $1,367.65 |
| VermontVermont | — | $1,245.38 |
| Rest of WashingtonWashington | — | $1,330.74 |
| King County, WAWashington | — | $1,406.23 |
| WisconsinWisconsin | — | $1,191.42 |
| West VirginiaWest Virginia | — | $1,457.81 |
| WyomingWyoming | — | $1,305.07 |
35533 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
How the 35533 rate is calculated
Each of 35533’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 35533
RVUs × geographic indexes × conversion factor
Work29.17
29.17 RVUs× 1.000 GPCI
Practice expense4.39
4.39 RVUs× 1.000 GPCI
Malpractice7.45
7.45 RVUs× 1.000 GPCI
Adjusted RVUs
41.0100
Conversion factor
$33.4009
Medicare rate
$1,369.77
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Virginia inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
4,350
- Code
- 35533
- Physician work
- 29.17
- Practice expense
- 4.39
- Malpractice
- 7.45
GPCI2026.csv
106
- Locality
- Virginia
- Physician work
- 1.000
- Practice expense
- 0.983
- Malpractice
- 0.706
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 29.17 | × 1.000 | 29.1700 |
| Practice expense | 4.39 | × 0.983 | 4.3154 |
| Malpractice | 7.45 | × 0.706 | 5.2597 |
| Total RVUs | 38.7451 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Virginia$1294.12
Facility: (29.17 × 1 + 4.39 × 0.983 + 7.45 × 0.706) × $33.4009 = $1294.12
Payment rules and modifiers for 35533
35533 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 35533
Arterial bypass, vein graft, axillary-femoral-femoral
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.84/0.07 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 35533
Arterial bypass, vein graft, axillary-femoral-femoral
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
35533 without 50 · national facility
$1,369.77
Arterial bypass, vein graft, axillary-femoral-femoral
35533-50 · Bilateral: 150%
$2,054.66
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
How 35533 has changed in Virginia
35533 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $1,294.12 | RVU26D |
| 2026-07-01 | Not available in this setting | $1,294.12 | RVU26C |
| 2026-04-01 | Not available in this setting | $1,294.12 | RVU26B |
| 2026-01-01 | Not available in this setting | $1,294.12 | RVU26A |
| 2025-10-01 | Not available in this setting | $1,370.45 | RVU25D |
| 2025-07-01 | Not available in this setting | $1,370.45 | RVU25C |
| 2025-04-01 | Not available in this setting | $1,370.45 | RVU25B |
| 2025-01-01 | Not available in this setting | $1,370.45 | RVU25A |
| 2024-10-01 | Not available in this setting | $1,407.11 | RVU24D |
| 2024-07-01 | Not available in this setting | $1,407.11 | RVU24C |
| 2024-04-01 | Not available in this setting | $1,407.11 | RVU24B |
| 2024-03-09 | Not available in this setting | $1,407.11 | RVU24AR |
| 2024-01-01 | Not available in this setting | $1,384.15 | RVU24A |
| 2023-10-01 | Not available in this setting | $1,443.91 | RVU23D |
| 2023-07-01 | Not available in this setting | $1,443.91 | RVU23C |
| 2023-04-01 | Not available in this setting | $1,443.91 | RVU23B |
| 2023-01-01 | Not available in this setting | $1,443.91 | RVU23A |
| 2022-10-01 | Not available in this setting | $1,499.38 | RVU22D |
| 2022-07-01 | Not available in this setting | $1,499.38 | RVU22C |
| 2022-04-01 | Not available in this setting | $1,499.38 | RVU22B |
| 2022-01-01 | Not available in this setting | $1,499.38 | RVU22A |
| 2021-10-01 | Not available in this setting | $1,500.10 | RVU21D |
| 2021-07-01 | Not available in this setting | $1,500.10 | RVU21C |
| 2021-04-01 | Not available in this setting | $1,500.10 | RVU21B |
| 2021-01-01 | Not available in this setting | $1,500.10 | RVU21A |
| 2020-10-01 | Not available in this setting | $1,552.28 | RVU20D |
| 2020-07-01 | Not available in this setting | $1,552.28 | RVU20C |
| 2020-04-01 | Not available in this setting | $1,552.28 | RVU20B |
| 2020-01-01 | Not available in this setting | $1,552.28 | RVU20A |
| 2019-10-01 | Not available in this setting | $1,541.04 | RVU19D |
| 2019-07-01 | Not available in this setting | $1,541.04 | RVU19C |
| 2019-04-01 | Not available in this setting | $1,536.13 | RVU19B |
| 2019-01-01 | Not available in this setting | $1,536.13 | RVU19A |
| 2018-10-01 | Not available in this setting | $1,547.39 | RVU18D |
| 2018-07-01 | Not available in this setting | $1,547.39 | RVU18C |
| 2018-04-01 | Not available in this setting | $1,547.39 | RVU18B |
| 2018-01-01 | Not available in this setting | $1,547.39 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $1,539.25 | RVU17D |
| 2017-07-01 | Not available in this setting | $1,539.25 | RVU17C |
| 2017-04-01 | Not available in this setting | $1,539.25 | RVU17B |
| 2017-01-01 | Not available in this setting | $1,539.25 | RVU17A |
| 2016-10-01 | Not available in this setting | $1,541.11 | RVU16D |
| 2016-07-01 | Not available in this setting | $1,541.11 | RVU16C |
| 2016-04-01 | Not available in this setting | $1,541.11 | RVU16B |
| 2016-01-01 | Not available in this setting | $1,541.11 | RVU16A |
| 2015-10-01 | Not available in this setting | $1,556.75 | RVU15D |
| 2015-07-01 | Not available in this setting | $1,556.75 | RVU15C |
| 2015-04-01 | Not available in this setting | $1,549.00 | RVU15B |
| 2015-01-01 | Not available in this setting | $1,549.00 | RVU15A |
| 2014-10-01 | Not available in this setting | $1,549.28 | RVU14D |
| 2014-07-01 | Not available in this setting | $1,549.28 | RVU14C |
| 2014-04-01 | Not available in this setting | $1,549.28 | RVU14B |
| 2014-01-01 | Not available in this setting | $1,549.28 | RVU14A |
| 2013-10-01 | Not available in this setting | $1,503.69 | RVU13D |
| 2013-07-01 | Not available in this setting | $1,503.69 | RVU13C |
| 2013-04-01 | Not available in this setting | $1,503.69 | RVU13B |
| 2013-01-01 | Not available in this setting | $1,503.69 | RVU13AR |
Where the Virginia rate applies
Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.
- Abbs Valley
- Abingdon
- Accomac
- Adwolf
- Afton
- Alberta
- Aldie
- Allison Gap
35533 billing questions
How does 35533 differ from 35521?
35533 covers an axillary inflow with a bypass continuing to both femoral arteries. 35521 describes an axillary-to-femoral bypass with a single femoral target.
Does the code describe a vein graft?
Yes. The bypass uses a vein conduit; the operative report should identify the conduit and the full bypass route.
Is 35533 the right code for a femoral-femoral bypass alone?
No. A femoral-femoral bypass without the axillary inflow is a different route; 35558 is the related vein-graft code to compare.
What should the operative report document?
Document the axillary artery used for inflow, both femoral anastomosis sites, and the vein conduit. These details distinguish the full route from a single-limb bypass.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeons are paid only with supporting documentation; team surgery is not permitted.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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