CPT code 35661: Femoral bypass, femoral-to-femoral, nonvein graft2026 Medicare rate & RVUs in Missouri
Reports a nonvein crossover graft between femoral arteries to restore blood flow to a leg affected by inadequate arterial inflow.
CMS doesn’t publish an office rate for 35661 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
Your location
On this page 9 sections
What 35661 covers
This operation creates an extra-anatomic crossover graft between the femoral arteries, routing blood from a patent donor-side artery to the opposite leg when native inflow is inadequate. It is commonly performed for unilateral iliac or aortoiliac occlusive disease when a femoral artery can supply the ischemic limb. The code represents a conduit other than vein, commonly prosthetic, placed by a vascular surgeon in an operating room; it is not a femoral-to-popliteal bypass.
The operative report should identify the inflow and outflow arteries, the anastomosis sites, conduit type, indication, and any additional distinct procedures. The 90-day global period includes 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 others are subject to the standard multiple procedure reduction. CMS classifies this as bilateral: modifier 50 is paid at 150% for a qualifying bilateral service, but the crossover’s connection between both groins alone does not establish a bilateral service. 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 35661 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $969.22 |
| Metropolitan St. Louis, MO | Unavailable | $975.39 |
| Rest of Missouri | Unavailable | $957.06 |
How the 35661 rate is calculated
Each of 35661’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 · 35661
RVUs × geographic indexes × conversion factor
Work19.84
19.84 RVUs× 1.000 GPCI
Practice expense4.53
4.53 RVUs× 1.000 GPCI
Malpractice5.04
5.04 RVUs× 1.000 GPCI
Adjusted RVUs
29.4100
Conversion factor
$33.4009
Medicare rate
$982.32
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 35661
35661 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 35661
Femoral bypass, femoral-to-femoral, nonvein graft
| 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 · 35661
Femoral bypass, femoral-to-femoral, nonvein graft
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
35661 without 50 · national facility
$982.32
Femoral bypass, femoral-to-femoral, nonvein graft
35661-50 · Bilateral: 150%
$1,473.48
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).
35661 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 35654Arterial bypassAxillary inflow, both femorals
- Both codes describe a femoral-femoral bypass route using a nonvein graft. Choose 35654 when the graft’s inflow is axillary rather than femoral.
- 35646Aortic bypassTo both femoral arteries
- 35646 describes aortobifemoral bypass, with aortic inflow and bilateral femoral outflow. This code describes a femoral-to-femoral crossover.
- 35656Arterial bypassFemoral to popliteal, non-vein
- 35656 is for a bypass from a femoral artery to a popliteal artery. This code has the opposite femoral artery as its outflow target.
- 35665Arterial bypassIliac-to-femoral, nonvein graft
- 35665 describes an iliofemoral bypass. Use this code when the bypass runs from one femoral artery to the other.
35661 billing questions
Does this code describe a vein graft?
No. It describes a femoral-to-femoral bypass using a conduit other than vein, commonly a prosthetic graft.
Should modifier 50 be used because the graft connects both groins?
Not for that reason alone. The femoral-to-femoral crossover inherently involves both sides; CMS applies the bilateral payment rule when a qualifying bilateral service is reported with modifier 50.
How does this differ from a femoral-popliteal bypass?
This graft crosses from one femoral artery to the opposite femoral artery. A femoral-popliteal bypass has a popliteal artery as its distal target.
Are related postoperative visits included?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction.
Can an assistant or co-surgeon be reported?
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
Fee sheets · Coming soon
Put 35661 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist