CPT code 35656: Arterial bypass, femoral to popliteal, non-vein2026 Medicare rate & RVUs

Medicare pays $971.97 for 35656 nationally in a facility.

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

What 35656 covers

A vascular surgeon creates a route from a femoral artery to a popliteal artery using a graft other than vein, commonly a prosthetic conduit, to bypass an obstructed arterial segment. The operation is generally performed in a hospital operating room for lower-extremity arterial disease when revascularization is needed. The operative report should identify the inflow and popliteal target, the non-vein conduit, the side treated, and the bypass performed.

Choose this code for the femoral-to-popliteal route with a non-vein graft; a vein conduit or a more distal tibial or peroneal target points to a different code. 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 the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons are paid only with 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 35656 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

35656 rates by state

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

How the 35656 rate is calculated

Each of 35656’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.

Payment rules and modifiers for 35656

35656 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

35656 compared with similar codes

How to choose

35556Arterial bypassVein graft, femoral to popliteal

Use 35556 for the same femoral-to-popliteal route when the conduit is vein; 35656 is for a non-vein graft.

35666Leg bypassFemoral to tibial/peroneal

Both use a non-vein graft, but 35666 reaches an anterior tibial, posterior tibial, or peroneal artery rather than the popliteal artery.

35671Leg bypassPopliteal to tibial/peroneal

35671 describes a popliteal-to-tibial or peroneal bypass; 35656 begins at the femoral artery and ends at the popliteal artery.

35661Femoral bypassFemoral-to-femoral, nonvein graft

35661 connects femoral arteries, typically across the pelvis; 35656 connects a femoral artery to a popliteal artery.

Codes related to 35656

Related codes aren’t interchangeable: bill the code that matches the service performed.

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

Open CMS sourceHow we calculate rates