CPT code 35646: Aortic bypass, to both femoral arteries2026 Medicare rate & RVUs in New Mexico

Reports a non-vein bypass from the aorta to both femoral arteries, commonly performed to restore lower-extremity blood flow in aortoiliac occlusive disease.

CMS RVU26DEffective Oct 1, 2026One payment locality872 Medicare services in 2024

In New Mexico, Medicare pays $1,581.70 for 35646 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$1,581.70Hospital or facility

Check a contract rate as a % of Medicare · 35646 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 35646 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in New Mexico
  2. What 35646 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 35646 covers

A vascular surgeon uses a conduit other than vein, typically a synthetic graft, to route blood from the aorta to the femoral artery in each groin. This operation is commonly performed in an operating room for extensive aortoiliac occlusive disease causing significant lower-extremity ischemia. The graft’s two limbs provide anatomic outflow to both sides; the operative report should identify the aortic inflow, both femoral targets, and conduit material.

Report this code when the bypass runs from the aorta to both femoral arteries using a non-vein conduit. Documentation should establish the indication, graft route and material, and the two distal anastomoses. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. An assistant at surgery may be paid; 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.

How New Mexico compares for 35646

Across 109 of 109 payment localities, the facility rate for 35646 runs from $1,346.05 in Wisconsin to $1,970.43 in Alaska. New Mexico pays $1,581.70. The RVUs are the same everywhere; the geographic indexes change the dollars.

35646 in New Mexico vs other payment areas
  1. New Mexico · this page$1,581.70
  2. Los Angeles, CA · California$1,531.35−$50.35
  3. Washington, DC area · District of Columbia$1,666.86+$85.16
  4. Miami, FL · Florida$1,968.40+$386.70
  5. Chicago, IL · Illinois$1,905.01+$323.31
  6. Manhattan, NY · New York$1,803.54+$221.84
  7. Alaska · Alaska$1,970.43+$388.73

Other areas in New Mexico first, then benchmark localities. Bars start at $0.

Every other payment area

35646 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$1,400.18
ArkansasArkansas—$1,383.13
ArizonaArizona—$1,497.75
Bakersfield, CACalifornia—$1,475.65
Chico, CACalifornia—$1,453.59
El Centro, CACalifornia—$1,454.95
Fresno, CACalifornia—$1,453.59
Hanford, CACalifornia—$1,453.59

35646 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
35646 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 35646 in every payment locality

How the 35646 rate is calculated

Each of 35646’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 · 35646

RVUs × geographic indexes × conversion factor

Office or facility?

Work32.16

32.16 RVUs× 1.000 GPCI

Practice expense5.87

5.87 RVUs× 1.000 GPCI

Malpractice8.17

8.17 RVUs× 1.000 GPCI

Adjusted RVUs

46.2000

Conversion factor

$33.4009

Medicare rate

$1,543.12

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact New Mexico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,388

Code
35646
Physician work
32.16
Practice expense
5.87
Malpractice
8.17

GPCI2026.csv

77

Locality
New Mexico
Physician work
1.000
Practice expense
0.917
Malpractice
1.201
Facility calculation for 35646 in New Mexico
ComponentRVULocality factorAdjusted
Physician work32.16× 1.00032.1600
Practice expense5.87× 0.9175.3828
Malpractice8.17× 1.2019.8122
Total RVUs47.3550
Conversion factor× 33.4009

Facility rate, New Mexico$1581.70

Facility: (32.16 × 1 + 5.87 × 0.917 + 8.17 × 1.201) × $33.4009 = $1581.70

Open 35646 in the RVU calculator

Payment rules and modifiers for 35646

35646 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 35646

Aortic bypass, to both femoral arteries

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)0The 150% bilateral adjustment doesn’t apply.
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 · 35646

Aortic bypass, to both femoral arteries

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 51 · payment effect

With and without the modifier

35646 without 51 · national facility

$1,543.12

Aortic bypass, to both femoral arteries

35646-51 · Second procedure: 50%

$771.56

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

How 35646 has changed in New Mexico

35646 · 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$1,581.70RVU26D
2026-07-01Not available in this setting$1,581.70RVU26C
2026-04-01Not available in this setting$1,581.70RVU26B
2026-01-01Not available in this setting$1,581.70RVU26A
2025-10-01Not available in this setting$1,630.93RVU25D
2025-07-01Not available in this setting$1,630.93RVU25C
2025-04-01Not available in this setting$1,630.93RVU25B
2025-01-01Not available in this setting$1,630.93RVU25A
2024-10-01Not available in this setting$1,680.42RVU24D
2024-07-01Not available in this setting$1,680.42RVU24C
2024-04-01Not available in this setting$1,680.42RVU24B
2024-03-09Not available in this setting$1,680.42RVU24AR
2024-01-01Not available in this setting$1,653.00RVU24A
2023-10-01Not available in this setting$1,701.91RVU23D
2023-07-01Not available in this setting$1,701.91RVU23C
2023-04-01Not available in this setting$1,701.91RVU23B
2023-01-01Not available in this setting$1,701.91RVU23A
2022-10-01Not available in this setting$1,745.92RVU22D
2022-07-01Not available in this setting$1,745.92RVU22C
2022-04-01Not available in this setting$1,745.92RVU22B
2022-01-01Not available in this setting$1,745.92RVU22A
2021-10-01Not available in this setting$1,752.22RVU21D
2021-07-01Not available in this setting$1,752.22RVU21C
2021-04-01Not available in this setting$1,752.22RVU21B
2021-01-01Not available in this setting$1,752.22RVU21A
2020-10-01Not available in this setting$1,828.97RVU20D
2020-07-01Not available in this setting$1,828.97RVU20C
2020-04-01Not available in this setting$1,828.97RVU20B
2020-01-01Not available in this setting$1,828.97RVU20A
2019-10-01Not available in this setting$1,833.81RVU19D
2019-07-01Not available in this setting$1,833.81RVU19C
2019-04-01Not available in this setting$1,833.81RVU19B
2019-01-01Not available in this setting$1,833.81RVU19A
2018-10-01Not available in this setting$1,839.24RVU18D
2018-07-01Not available in this setting$1,839.24RVU18C
2018-04-01Not available in this setting$1,839.24RVU18B
2018-01-01Not available in this setting$1,839.24RVU18AR1
2017-10-01Not available in this setting$1,835.19RVU17D
2017-07-01Not available in this setting$1,835.19RVU17C
2017-04-01Not available in this setting$1,835.19RVU17B
2017-01-01Not available in this setting$1,835.19RVU17A
2016-10-01Not available in this setting$1,836.72RVU16D
2016-07-01Not available in this setting$1,836.72RVU16C
2016-04-01Not available in this setting$1,836.72RVU16B
2016-01-01Not available in this setting$1,836.72RVU16A
2015-10-01Not available in this setting$1,844.04RVU15D
2015-07-01Not available in this setting$1,844.04RVU15C
2015-04-01Not available in this setting$1,834.87RVU15B
2015-01-01Not available in this setting$1,834.87RVU15A
2014-10-01Not available in this setting$1,816.89RVU14D
2014-07-01Not available in this setting$1,816.89RVU14C
2014-04-01Not available in this setting$1,816.89RVU14B
2014-01-01Not available in this setting$1,816.89RVU14A
2013-10-01Not available in this setting$1,758.51RVU13D
2013-07-01Not available in this setting$1,758.51RVU13C
2013-04-01Not available in this setting$1,758.51RVU13B
2013-01-01Not available in this setting$1,758.51RVU13AR

Price 35646 for an earlier date of service

Where the New Mexico rate applies

New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.

  • Abeytas
  • Abiquiu
  • Acomita Lake
  • Adelino
  • Agua Fria
  • Alamillo
  • Alamo
  • Alamogordo

Browse all communities in New Mexico

35646 billing questions

How does 35646 differ from 35647?

35646 describes an aortic bypass to both femoral arteries. 35647 is the related aortofemoral code for a bypass to one femoral artery.

Does the conduit material affect code selection?

Yes. 35646 is for a conduit other than vein, typically a synthetic graft. For an aortofemoral bypass using vein, compare 35521.

Is a separate bypass code reported for each graft limb?

No. The two femoral destinations are part of the aortobifemoral bypass represented by 35646; document both distal targets in the operative report.

What documentation supports reporting 35646?

The operative report should show aortic inflow, bypass to both femoral arteries, the graft route, and use of a non-vein conduit.

How does the multiple-procedure payment rule affect another same-session procedure?

When another procedure is performed in the same session, CMS pays the highest-valued procedure in full and applies the standard 50% reduction to the others.

What are the assistant and co-surgeon payment rules?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; CMS does not permit team surgery.

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 35646PPRRVU2026_Oct_nonQPP.csv, line 4,388 (RVU26D)
Geographic factors for New MexicoGPCI2026.csv, line 77 (RVU26D)

Open CMS sourceHow we calculate rates

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