CPT code 35566: Leg bypass, femoral to tibial or peroneal2026 Medicare rate & RVUs in California
Reports a vein-conduit arterial bypass from a femoral artery to a distal tibial or peroneal artery to restore blood flow to the lower leg or foot.
CMS doesn’t publish an office rate for 35566 in California.
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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What 35566 covers
A vascular surgeon uses a vein conduit to route blood from a femoral artery to an anterior tibial, posterior tibial, or peroneal artery. The distal target is in the lower leg, beyond the popliteal level. This bypass is commonly performed in a hospital operating room for severe peripheral arterial disease when restoring flow to the foot or lower leg is needed. The operative report should identify the inflow artery, the specific outflow vessel, the conduit, and the bypass performed.
Choose this code for the femoral inflow and tibial or peroneal outflow combination; a femoral-to-popliteal bypass or a bypass beginning at a tibial artery has a different code. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons require 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 35566 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | Unavailable | $1,433.65 |
| Chico, CA | Unavailable | $1,411.89 |
| El Centro, CA | Unavailable | $1,413.23 |
| Fresno, CA | Unavailable | $1,411.89 |
| Hanford, CA | Unavailable | $1,411.89 |
| Los Angeles, CA | Unavailable | $1,487.20 |
| Madera, CA | Unavailable | $1,411.89 |
| Marin County, CA | Unavailable | $1,529.54 |
| Merced, CA | Unavailable | $1,411.89 |
| Modesto, CA | Unavailable | $1,411.89 |
| Napa, CA | Unavailable | $1,492.55 |
| Oxnard, CA | Unavailable | $1,462.29 |
| Redding, CA | Unavailable | $1,411.89 |
| Rest of California | Unavailable | $1,411.89 |
| Riverside, CA | Unavailable | $1,498.28 |
| Sacramento, CA | Unavailable | $1,443.90 |
| Salinas, CA | Unavailable | $1,437.91 |
| San Benito County, CA | Unavailable | $1,571.80 |
| San Diego, CA | Unavailable | $1,445.10 |
| San Francisco, CA | Unavailable | $1,520.39 |
| San Luis Obispo, CA | Unavailable | $1,419.58 |
| Santa Clara County, CA | Unavailable | $1,534.38 |
| Santa Cruz, CA | Unavailable | $1,437.40 |
| Santa Maria, CA | Unavailable | $1,436.01 |
| Santa Rosa, CA | Unavailable | $1,449.21 |
| Stockton, CA | Unavailable | $1,411.89 |
| Vallejo, CA | Unavailable | $1,479.36 |
| Visalia, CA | Unavailable | $1,411.89 |
| Yuba City, CA | Unavailable | $1,411.89 |
How the 35566 rate is calculated
Each of 35566’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 · 35566
RVUs × geographic indexes × conversion factor
Work31.54
31.54 RVUs× 1.000 GPCI
Practice expense5.36
5.36 RVUs× 1.000 GPCI
Malpractice8.06
8.06 RVUs× 1.000 GPCI
Adjusted RVUs
44.9600
Conversion factor
$33.4009
Medicare rate
$1,501.70
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 35566
35566 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 35566
Leg bypass, femoral to tibial or peroneal
| 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 · 35566
Leg bypass, femoral to tibial or peroneal
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
35566 without 50 · national facility
$1,501.70
Leg bypass, femoral to tibial or peroneal
35566-50 · Bilateral: 150%
$2,252.55
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).
35566 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 35556Arterial bypassVein graft, femoral to popliteal
- 35556 ends at the popliteal artery. This code is for a more distal outflow target: an anterior tibial, posterior tibial, or peroneal artery.
- 35570Arterial bypassTibial-to-tibial or peroneal
- 35570 describes a bypass beginning at a tibial artery and ending at another tibial or peroneal artery. This code begins at a femoral artery.
- 35585Vein bypassFemoral to tibial or peroneal
- 35585 is the in-situ vein option for a femoral-to-tibial or peroneal route. This code represents the other vein-bypass approach.
- 35666Leg bypassFemoral to tibial/peroneal
- 35666 uses a conduit other than vein for the femoral-to-tibial or peroneal bypass; this code is the vein-conduit option.
35566 billing questions
How is this different from a femoral-popliteal bypass?
This code is for a femoral inflow with a distal anterior tibial, posterior tibial, or peroneal outflow. A bypass ending at the popliteal artery is a different service.
When would a tibial-to-tibial bypass code be used instead?
Use the tibial-to-tibial or tibial-to-peroneal code when the bypass begins at a tibial artery rather than a femoral artery.
What operative details support reporting this code?
Document the femoral inflow vessel, the named tibial or peroneal outflow target, and the vein conduit used for the bypass.
How does Medicare handle bilateral reporting?
When the procedure is performed bilaterally and reported with modifier 50, Medicare pays at 150% under the CMS rule for this code.
What payment rules apply when other procedures are performed in the same session?
The highest-valued procedure is paid in full and other procedures are paid at 50%. The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
An assistant at surgery 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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