CPT code 35558: Arterial bypass, femoral-femoral, vein graft2026 Medicare rate & RVUs in Missouri
Reports open arterial revascularization connecting the femoral arteries with a vein conduit, typically to route blood around an obstructed iliac inflow pathway.
CMS doesn’t publish an office rate for 35558 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 35558 covers
A vascular surgeon creates a bypass between the femoral arteries using a vein conduit, routing blood from the better-perfused side to the opposite leg. The operation is generally performed in a hospital operating room for selected patients with lower-extremity ischemia from aortoiliac or iliac occlusive disease. The operative report should identify the donor and recipient arteries, the vein conduit, and the bypass configuration; a prosthetic graft is coded differently.
Report 35558 for the femoral-to-femoral route when a vein graft is used, not for a prosthetic fem-fem bypass. The CMS global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 bilateral reporting is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires 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.
Where 35558 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $1,089.09 |
| Metropolitan St. Louis, MO | Unavailable | $1,095.92 |
| Rest of Missouri | Unavailable | $1,076.17 |
How the 35558 rate is calculated
Each of 35558’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 · 35558
RVUs × geographic indexes × conversion factor
Work22.55
22.55 RVUs× 1.000 GPCI
Practice expense4.80
4.80 RVUs× 1.000 GPCI
Malpractice5.68
5.68 RVUs× 1.000 GPCI
Adjusted RVUs
33.0300
Conversion factor
$33.4009
Medicare rate
$1,103.23
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 35558
35558 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 35558
Arterial bypass, femoral-femoral, vein graft
| 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 · 35558
Arterial bypass, femoral-femoral, vein graft
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
35558 without 50 · national facility
$1,103.23
Arterial bypass, femoral-femoral, vein graft
35558-50 · Bilateral: 150%
$1,654.85
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).
35558 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 35661Femoral bypassFemoral-to-femoral, nonvein graft
- Both describe a femoral-femoral bypass, but 35558 uses a vein conduit and 35661 uses a conduit other than vein.
- 35556Arterial bypassVein graft, femoral to popliteal
- Both are vein-graft arterial bypass procedures; 35556 routes between the femoral and popliteal arteries, while 35558 connects the femoral arteries.
- 35533Arterial bypassVein graft, axillary-femoral-femoral
- 35533 describes an axillary-to-femoral-to-femoral bypass configuration. Use 35558 for the femoral-to-femoral route when the documented conduit is vein.
35558 billing questions
How is 35558 distinguished from a prosthetic fem-fem bypass?
35558 is for the femoral-to-femoral bypass using a vein conduit. A bypass using a non-vein conduit is represented by 35661.
What operative details support reporting 35558?
Document the femoral donor and recipient arteries, the bypass route, and use of a vein conduit. The record should make clear that the graft connects the femoral arteries.
Does the 90-day global period include routine postoperative care?
Yes. The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures performed in that session receive the standard multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How is bilateral reporting handled?
When the service is appropriately reported as bilateral with modifier 50, CMS pays it at 150%.
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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