CPT code 35665: Arterial bypass, iliac-to-femoral, nonvein graft2026 Medicare rate & RVUs in Maryland
Reports a surgical bypass using a nonvein conduit from an iliac artery to a femoral artery to reroute blood flow around diseased or obstructed vessels.
CMS doesn’t publish an office rate for 35665 in Maryland.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
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 in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore area, MD | Unavailable | $1,132.68 |
| Rest of Maryland | Unavailable | $1,060.20 |
| Washington, DC area | Unavailable | $1,153.72 |
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.
How the rate is built · 35665
RVUs × geographic indexes × conversion factor
Work21.79
21.79 RVUs× 1.000 GPCI
Practice expense4.62
4.62 RVUs× 1.000 GPCI
Malpractice5.51
5.51 RVUs× 1.000 GPCI
Adjusted RVUs
31.9200
Conversion factor
$33.4009
Medicare rate
$1,066.16
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 35665
35665 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 35665
Arterial bypass, iliac-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 · 35665
Arterial bypass, iliac-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
35665 without 50 · national facility
$1,066.16
Arterial bypass, iliac-to-femoral, nonvein graft
35665-50 · Bilateral: 150%
$1,599.24
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).
35665 compared with similar codes
Compare codes · National
5 codes, side by side
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.
35665 billing questions
When should 35665 be chosen instead of 35565?
Use 35665 for an iliac-to-femoral bypass using a nonvein conduit. The corresponding vein-conduit bypass is reported with 35565.
How does 35665 differ from 35663?
Both use an iliac artery as the bypass source, but 35665 ends at a femoral artery; 35663 connects one iliac artery to another.
What operative details support reporting this code?
Document the iliac origin, femoral destination, side, graft material, and completed bypass route. The conduit and both ends of the reconstruction distinguish this service from neighboring bypass codes.
How is bilateral reporting handled?
When the procedure is bilateral, report modifier 50; CMS pays the bilateral procedure at 150%.
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 with supporting documentation, and 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
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