CPT code 35665: Arterial bypass, iliac-to-femoral, nonvein graft2026 Medicare rate & RVUs

Medicare pays $1,066.16 for 35665 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 35665 covers

A vascular surgeon creates a new route for arterial blood between an iliac artery and a femoral artery, using a conduit other than vein. The operation is typically performed in an operating room for lower-extremity arterial disease when the chosen reconstruction connects these specific inflow and outflow sites. The operative report should identify the source artery, recipient artery, side, conduit, and bypass route so the service can be distinguished from other aortoiliac or femoral bypasses.

Select this code for the iliac-to-femoral route with a nonvein graft; a vein conduit or different origin or destination points to a different code. 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 other procedures are subject to the standard 50% reduction. For a bilateral procedure reported with modifier 50, payment is 150%. An assistant at surgery may be paid; co-surgeons require 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 35665 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

35665 rates by state

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

How the 35665 rate is calculated

Each of 35665’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 35665

35665 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

35665 compared with similar codes

How to choose

35565Arterial bypassVein conduit, iliac-to-femoral

The route is also iliac-to-femoral, but 35565 is selected when the bypass conduit is vein rather than a nonvein graft.

35663Arterial bypassIliac-to-iliac, nonvein conduit

Both are nonvein bypasses involving iliac arteries. Choose 35665 when the outflow is femoral; 35663 connects iliac artery to iliac artery.

35647Aortic bypassSingle femoral target

Both end at a femoral artery and use a nonvein graft, but 35647 begins at the aorta rather than an iliac artery.

35661Femoral bypassFemoral-to-femoral, nonvein graft

35661 describes a nonvein bypass from one femoral artery to the other; 35665 begins at an iliac artery and ends at a femoral artery.

Codes related to 35665

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