CPT code 35585: Vein bypass, femoral to tibial or peroneal2026 Medicare rate & RVUs in Texas
Reports a vein bypass from the femoral artery to a tibial or peroneal artery to route blood around a distal lower-extremity arterial obstruction.
CMS doesn’t publish an office rate for 35585 in Texas.
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 35585 covers
A vascular surgeon creates a bypass from the femoral artery to a tibial or peroneal artery using a vein conduit, directing blood around an obstructed or severely diseased segment. The operation is generally performed in a hospital operating room for lower-extremity arterial disease when a distal target is needed to restore flow. The operative report should identify the inflow artery, the specific tibial or peroneal outflow artery, and the vein used as the bypass conduit.
Select this code when the bypass begins at the femoral artery, reaches a tibial or peroneal artery, and uses vein; a different origin, target, or conduit may point to a neighboring bypass code. Documentation should establish the bypass route, target vessel, conduit, and laterality. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For bilateral procedures reported with modifier 50, CMS pays at 150%. When multiple procedures occur in one session, the highest-valued procedure is paid in full and others at 50%. 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 35585 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | $1,490.22 |
| Beaumont, TX | Unavailable | $1,472.25 |
| Brazoria, TX | Unavailable | $1,455.58 |
| Dallas, TX | Unavailable | $1,478.56 |
| Fort Worth, TX | Unavailable | $1,480.21 |
| Galveston, TX | Unavailable | $1,468.88 |
| Houston, TX | Unavailable | $1,616.40 |
| Rest of Texas | Unavailable | $1,472.48 |
How the 35585 rate is calculated
Each of 35585’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 · 35585
RVUs × geographic indexes × conversion factor
Work31.54
31.54 RVUs× 1.000 GPCI
Practice expense5.55
5.55 RVUs× 1.000 GPCI
Malpractice8.06
8.06 RVUs× 1.000 GPCI
Adjusted RVUs
45.1500
Conversion factor
$33.4009
Medicare rate
$1,508.05
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 35585
35585 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 35585
Vein 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 · 35585
Vein 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
35585 without 50 · national facility
$1,508.05
Vein bypass, femoral to tibial or peroneal
35585-50 · Bilateral: 150%
$2,262.08
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).
35585 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 35583Vein bypassIn situ, femoral to popliteal
- Use 35583 for a vein bypass from the femoral artery to the popliteal artery. This code applies when the distal target is a tibial or peroneal artery.
- 35587Vein bypassPopliteal to tibial/peroneal
- Use 35587 when a vein bypass begins at the popliteal artery and reaches a tibial or peroneal artery; this code begins at the femoral artery.
- 35566Leg bypassFemoral to tibial or peroneal
- This code describes the femoral-to-tibial or peroneal route with a vein conduit. 35566 represents a similar route using a conduit other than vein.
35585 billing questions
How is this code distinguished from 35583?
Both use a vein conduit, but 35583 is for a femoral-to-popliteal bypass. Use this code when the distal target is a tibial or peroneal artery.
How is this code distinguished from 35587?
35587 describes a vein bypass from the popliteal artery to a tibial or peroneal artery. This code requires the bypass to originate at the femoral artery.
Does the bypass conduit have to be vein?
Yes. This code describes a femoral-to-tibial or peroneal bypass using vein; a comparable route using a non-vein graft is represented by a different code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is a bilateral procedure reported?
Report modifier 50 for a bilateral procedure. CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment may be made. Co-surgeon payment requires 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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