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

Reports a lower-extremity arterial bypass using a non-vein graft to route blood from a femoral artery to a popliteal artery around obstructive disease.

CMS RVU26DEffective Oct 1, 2026One payment locality3.9K Medicare services in 2024

In Delaware, Medicare pays $956.56 for 35656 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$956.56Hospital or facility

Check a contract rate as a % of Medicare · 35656 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 35656 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Delaware
  2. What 35656 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 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.

How Delaware compares for 35656

Across 109 of 109 payment localities, the facility rate for 35656 runs from $849.07 in Wisconsin to $1,238.11 in Alaska. Delaware pays $956.56. The RVUs are the same everywhere; the geographic indexes change the dollars.

35656 in Delaware vs other payment areas
  1. Delaware · this page$956.56
  2. Los Angeles, CA · California$967.28+$10.72
  3. Washington, DC area · District of Columbia$1,051.30+$94.74
  4. Miami, FL · Florida$1,236.46+$279.90
  5. Chicago, IL · Illinois$1,196.61+$240.05
  6. Manhattan, NY · New York$1,135.89+$179.33
  7. Alaska · Alaska$1,238.11+$281.55

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

Every other payment area

35656 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$881.48
ArkansasArkansas—$870.67
ArizonaArizona—$943.37
Bakersfield, CACalifornia—$931.47
Chico, CACalifornia—$917.78
El Centro, CACalifornia—$918.62
Fresno, CACalifornia—$917.78
Hanford, CACalifornia—$917.78

35656 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
35656 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 35656 in every payment locality

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.

How the rate is built · 35656

RVUs × geographic indexes × conversion factor

Office or facility?

Work19.96

19.96 RVUs× 1.000 GPCI

Practice expense4.07

4.07 RVUs× 1.000 GPCI

Malpractice5.07

5.07 RVUs× 1.000 GPCI

Adjusted RVUs

29.1000

Conversion factor

$33.4009

Medicare rate

$971.97

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

The exact Delaware inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,392

Code
35656
Physician work
19.96
Practice expense
4.07
Malpractice
5.07

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Facility calculation for 35656 in Delaware
ComponentRVULocality factorAdjusted
Physician work19.96× 1.00520.0598
Practice expense4.07× 0.9884.0212
Malpractice5.07× 0.8994.5579
Total RVUs28.6389
Conversion factor× 33.4009

Facility rate, Delaware$956.56

Facility: (19.96 × 1.005 + 4.07 × 0.988 + 5.07 × 0.899) × $33.4009 = $956.56

Open 35656 in the RVU calculator

Payment rules and modifiers for 35656

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

CMS payment indicators · 35656

Arterial bypass, femoral to popliteal, non-vein

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 · 35656

Arterial bypass, femoral to popliteal, non-vein

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

35656 without 50 · national facility

$971.97

Arterial bypass, femoral to popliteal, non-vein

35656-50 · Bilateral: 150%

$1,457.96

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 35656 has changed in Delaware

35656 · 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$956.56RVU26D
2026-07-01Not available in this setting$956.56RVU26C
2026-04-01Not available in this setting$956.56RVU26B
2026-01-01Not available in this setting$956.56RVU26A
2025-10-01Not available in this setting$1,011.81RVU25D
2025-07-01Not available in this setting$1,011.81RVU25C
2025-04-01Not available in this setting$1,011.81RVU25B
2025-01-01Not available in this setting$1,011.81RVU25A
2024-10-01Not available in this setting$1,041.18RVU24D
2024-07-01Not available in this setting$1,041.18RVU24C
2024-04-01Not available in this setting$1,041.18RVU24B
2024-03-09Not available in this setting$1,041.18RVU24AR
2024-01-01Not available in this setting$1,024.18RVU24A
2023-10-01Not available in this setting$1,058.59RVU23D
2023-07-01Not available in this setting$1,058.59RVU23C
2023-04-01Not available in this setting$1,058.59RVU23B
2023-01-01Not available in this setting$1,058.59RVU23A
2022-10-01Not available in this setting$1,087.17RVU22D
2022-07-01Not available in this setting$1,087.17RVU22C
2022-04-01Not available in this setting$1,087.17RVU22B
2022-01-01Not available in this setting$1,087.17RVU22A
2021-10-01Not available in this setting$1,091.75RVU21D
2021-07-01Not available in this setting$1,091.75RVU21C
2021-04-01Not available in this setting$1,091.75RVU21B
2021-01-01Not available in this setting$1,091.75RVU21A
2020-10-01Not available in this setting$1,146.65RVU20D
2020-07-01Not available in this setting$1,146.65RVU20C
2020-04-01Not available in this setting$1,146.65RVU20B
2020-01-01Not available in this setting$1,146.65RVU20A
2019-10-01Not available in this setting$1,158.94RVU19D
2019-07-01Not available in this setting$1,158.94RVU19C
2019-04-01Not available in this setting$1,158.94RVU19B
2019-01-01Not available in this setting$1,158.94RVU19A
2018-10-01Not available in this setting$1,165.26RVU18D
2018-07-01Not available in this setting$1,165.26RVU18C
2018-04-01Not available in this setting$1,165.26RVU18B
2018-01-01Not available in this setting$1,165.26RVU18AR1
2017-10-01Not available in this setting$1,172.27RVU17D
2017-07-01Not available in this setting$1,172.27RVU17C
2017-04-01Not available in this setting$1,172.27RVU17B
2017-01-01Not available in this setting$1,172.27RVU17A
2016-10-01Not available in this setting$1,182.76RVU16D
2016-07-01Not available in this setting$1,182.76RVU16C
2016-04-01Not available in this setting$1,182.76RVU16B
2016-01-01Not available in this setting$1,182.76RVU16A
2015-10-01Not available in this setting$1,185.96RVU15D
2015-07-01Not available in this setting$1,185.96RVU15C
2015-04-01Not available in this setting$1,180.06RVU15B
2015-01-01Not available in this setting$1,180.06RVU15A
2014-10-01Not available in this setting$1,153.58RVU14D
2014-07-01Not available in this setting$1,153.58RVU14C
2014-04-01Not available in this setting$1,153.58RVU14B
2014-01-01Not available in this setting$1,153.58RVU14A
2013-10-01Not available in this setting$1,102.69RVU13D
2013-07-01Not available in this setting$1,102.69RVU13C
2013-04-01Not available in this setting$1,102.69RVU13B
2013-01-01Not available in this setting$1,102.69RVU13AR

Price 35656 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

  • Arden
  • Ardencroft
  • Ardentown
  • Bear
  • Bellefonte
  • Bethany Beach
  • Bethel
  • Blades

Browse all communities in Delaware

35656 billing questions

How does this differ from 35556?

Both describe a femoral-to-popliteal bypass, but 35656 is for a non-vein graft. Use 35556 when the bypass uses a vein graft.

Does the distal target determine whether this code applies?

Yes. The target must be a popliteal artery. A bypass extending to an anterior tibial, posterior tibial, or peroneal artery is represented by a different code.

What documentation supports reporting 35656?

The operative report should establish the femoral inflow, popliteal outflow, use of a non-vein graft, and the side or sides treated.

How is bilateral surgery handled?

CMS lists bilateral reporting with modifier 50, paid at 150%. The operative documentation should support bypasses on both sides.

What postoperative care is included?

The 90-day global period 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 when supporting documentation is provided.

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 35656PPRRVU2026_Oct_nonQPP.csv, line 4,392 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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