CPT code 35566: Leg bypass, femoral to tibial or peroneal2026 Medicare rate & RVUs in Puerto Rico

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 RVU26DEffective Oct 1, 2026One payment locality1.9K Medicare services in 2024

In Puerto Rico, Medicare pays $1,499.64 for 35566 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$1,499.64Hospital or facility

Check a contract rate as a % of Medicare · 35566 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 35566 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 35566 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

How Puerto Rico compares for 35566

Across 109 of 109 payment localities, the facility rate for 35566 runs from $1,307.89 in Wisconsin to $1,920.67 in Miami, FL. Puerto Rico pays $1,499.64. The RVUs are the same everywhere; the geographic indexes change the dollars.

35566 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$1,499.64
  2. Los Angeles, CA · California$1,487.20−$12.44
  3. Washington, DC area · District of Columbia$1,620.88+$121.24
  4. Miami, FL · Florida$1,920.67+$421.03
  5. Chicago, IL · Illinois$1,858.60+$358.96
  6. Manhattan, NY · New York$1,755.89+$256.25
  7. Alaska · Alaska$1,919.20+$419.56

Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.

Every other payment area

35566 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$1,362.49
ArkansasArkansas—$1,345.89
ArizonaArizona—$1,457.39
Bakersfield, CACalifornia—$1,433.65
Chico, CACalifornia—$1,411.89
El Centro, CACalifornia—$1,413.23
Fresno, CACalifornia—$1,411.89
Hanford, CACalifornia—$1,411.89

35566 rates by state

Office rate range in each state. Select a state to see its payment localities.

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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
35566 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

See 35566 in every payment locality

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

Office or facility?

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.

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,363

Code
35566
Physician work
31.54
Practice expense
5.36
Malpractice
8.06

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Facility calculation for 35566 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work31.54× 1.00031.5400
Practice expense5.36× 1.0115.4190
Malpractice8.06× 0.9857.9391
Total RVUs44.8981
Conversion factor× 33.4009

Facility rate, Puerto Rico$1499.64

Facility: (31.54 × 1 + 5.36 × 1.011 + 8.06 × 0.985) × $33.4009 = $1499.64

Open 35566 in the RVU calculator

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

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.84/0.07Share 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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

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).

When to use modifier 50

How 35566 has changed in Puerto Rico

35566 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

Base rate by release · bars start at $0 · select a bar to compare

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
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$1,499.64RVU26D
2026-07-01Not available in this setting$1,499.64RVU26C
2026-04-01Not available in this setting$1,499.64RVU26B
2026-01-01Not available in this setting$1,499.64RVU26A
2025-10-01Not available in this setting$1,569.62RVU25D
2025-07-01Not available in this setting$1,569.62RVU25C
2025-04-01Not available in this setting$1,569.62RVU25B
2025-01-01Not available in this setting$1,569.62RVU25A
2024-10-01Not available in this setting$1,614.87RVU24D
2024-07-01Not available in this setting$1,614.87RVU24C
2024-04-01Not available in this setting$1,614.87RVU24B
2024-03-09Not available in this setting$1,614.87RVU24AR
2024-01-01Not available in this setting$1,588.51RVU24A
2023-10-01Not available in this setting$1,640.53RVU23D
2023-07-01Not available in this setting$1,642.51RVU23C
2023-04-01Not available in this setting$1,642.51RVU23B
2023-01-01Not available in this setting$1,642.51RVU23A
2022-10-01Not available in this setting$1,688.61RVU22D
2022-07-01Not available in this setting$1,688.61RVU22C
2022-04-01Not available in this setting$1,688.61RVU22B
2022-01-01Not available in this setting$1,688.61RVU22A
2021-10-01Not available in this setting$1,692.96RVU21D
2021-07-01Not available in this setting$1,692.96RVU21C
2021-04-01Not available in this setting$1,692.96RVU21B
2021-01-01Not available in this setting$1,692.96RVU21A
2020-10-01Not available in this setting$1,753.08RVU20D
2020-07-01Not available in this setting$1,753.08RVU20C
2020-04-01Not available in this setting$1,753.08RVU20B
2020-01-01Not available in this setting$1,753.08RVU20A
2019-10-01Not available in this setting$1,742.35RVU19D
2019-07-01Not available in this setting$1,742.35RVU19C
2019-04-01Not available in this setting$1,742.35RVU19B
2019-01-01Not available in this setting$1,742.35RVU19A
2018-10-01Not available in this setting$1,751.72RVU18D
2018-07-01Not available in this setting$1,751.72RVU18C
2018-04-01Not available in this setting$1,751.72RVU18B
2018-01-01Not available in this setting$1,751.72RVU18AR1
2017-10-01Not available in this setting$1,617.05RVU17D
2017-07-01Not available in this setting$1,617.05RVU17C
2017-04-01Not available in this setting$1,617.05RVU17B
2017-01-01Not available in this setting$1,617.05RVU17A
2016-10-01Not available in this setting$1,483.54RVU16D
2016-07-01Not available in this setting$1,483.54RVU16C
2016-04-01Not available in this setting$1,483.54RVU16B
2016-01-01Not available in this setting$1,483.54RVU16A
2015-10-01Not available in this setting$1,487.14RVU15D
2015-07-01Not available in this setting$1,487.14RVU15C
2015-04-01Not available in this setting$1,479.74RVU15B
2015-01-01Not available in this setting$1,479.74RVU15A
2014-10-01Not available in this setting$1,482.07RVU14D
2014-07-01Not available in this setting$1,482.07RVU14C
2014-04-01Not available in this setting$1,482.07RVU14B
2014-01-01Not available in this setting$1,482.07RVU14A
2013-10-01Not available in this setting$1,432.00RVU13D
2013-07-01Not available in this setting$1,432.00RVU13C
2013-04-01Not available in this setting$1,432.00RVU13B
2013-01-01Not available in this setting$1,432.00RVU13AR

Price 35566 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

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
RVUs for 35566PPRRVU2026_Oct_nonQPP.csv, line 4,363 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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