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CPT code 35681: Composite bypass graft, one vein, one prosthetic segment2026 Medicare rate & RVUs

Reports a composite arterial bypass graft made with one vein segment and one prosthetic segment, alongside the primary code for the bypass route.

CMS RVU26DEffective Oct 1, 2026109 payment localities165 Medicare services in 2024

Medicare pays $71.81 for 35681 nationally in a facility.

Medicare rate · 35681

Composite bypass graft, one vein, one prosthetic segment

Office or facility?

Work RVUs
1.56
Total RVUs
2.15
Global days
ZZZ

National rate · 2026

$71.81

Facility setting, before claim adjustments.

See every locality for 35681 →Billed by an NP, PA or therapist? →

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

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 35681 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 35681 covers

A vascular surgeon may construct a composite bypass when the required conduit combines one segment of vein with one segment of prosthetic graft. This configuration can be used for an arterial bypass, such as a lower-extremity bypass, when the operative plan uses both materials to create the graft. The bypass route and recipient vessels determine the primary procedure code; this code identifies the composite graft construction.

Report 35681 only with the primary bypass procedure, not by itself. The surgeon’s operative report should identify the bypass route and document that the graft comprises one vein segment and one prosthetic segment. CMS treats this as an add-on code paid within the primary procedure’s global period. Select a different composite-graft code when the documented number or type of segments differs.

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 35681 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

35681 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$65.22
AlaskaUnavailable$92.28
ArizonaUnavailable$69.69
ArkansasUnavailable$64.44
Atlanta, GAUnavailable$74.76
Austin, TXUnavailable$70.76
Bakersfield, CAUnavailable$68.19
Baltimore area, MDUnavailable$76.28
Beaumont, TXUnavailable$70.29
Brazoria, TXUnavailable$69.23

35681 rates by state

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

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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
35681 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

How the 35681 rate is calculated

Each of 35681’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 · 35681

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.56

1.56 RVUs× 1.000 GPCI

Practice expense0.19

0.19 RVUs× 1.000 GPCI

Malpractice0.40

0.40 RVUs× 1.000 GPCI

Adjusted RVUs

2.1500

Conversion factor

$33.4009

Medicare rate

$71.81

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

Payment rules and modifiers for 35681

The CMS indicators that decide how 35681 is paid alongside other services.

CMS payment indicators · 35681

Composite bypass graft, one vein, one prosthetic segment

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
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.

What modifiers do to the payment

Modifier 80 · payment effect

With and without the modifier

35681 without 80 · national facility

$71.81

Composite bypass graft, one vein, one prosthetic segment

35681-80 · Assistant: 16%

$11.49

A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.

When to use modifier 80

35681 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 35681

    Composite bypass graft, one vein, one prosthetic segment1.56 wRVU

    Not priced

  • 35682

    Composite bypass, two vein segments7.01 wRVU

    Not priced

  • 35683

    Composite bypass graft, three or more segments8.28 wRVU

    Not priced

  • 35656

    Arterial bypass, femoral to popliteal, non-vein19.96 wRVU

    Not priced

How to choose

35682Composite bypassTwo vein segments
Choose 35682 when the composite graft uses two vein segments. Choose 35681 when it uses one vein segment and one prosthetic segment.
35683Composite bypass graftThree or more segments
Choose 35683 when the composite graft contains three or more segments; 35681 describes the one-vein, one-prosthetic-segment configuration.
35656Arterial bypassFemoral to popliteal, non-vein
35656 identifies a femoral-popliteal bypass route. Add 35681 when the documented graft for that bypass combines one vein segment and one prosthetic segment.

Codes related to 35681

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

Codes related to 35681
CodeHow it relatesNational office range
Primary code
35656Arterial bypass, femoral to popliteal, non-veinPrimary femoral-popliteal bypass code when that route uses this composite graft configuration.No office rate
35666Leg bypass, femoral to tibial/peronealPrimary femoral-to-distal-artery bypass code when paired with this composite graft configuration.No office rate
35671Leg bypass, popliteal to tibial/peronealPrimary popliteal-to-tibial or peroneal bypass code when paired with this graft configuration.No office rate
Same family
35682Composite bypass, two vein segmentsComposite bypass graft code for a configuration using two vein segments.No office rate
35683Composite bypass graft, three or more segmentsComposite bypass graft code for a configuration using three or more segments.No office rate

35681 billing questions

Can 35681 be reported by itself?

No. It is an add-on code and must be reported with the primary procedure that identifies the bypass route.

When is 35681 appropriate instead of 35682?

Use 35681 for a composite graft with one vein segment and one prosthetic segment. Code 35682 describes a composite graft made with two vein segments.

Does 35681 identify the bypass route?

No. The primary bypass code identifies the route and target vessels; 35681 reports the graft’s one-vein, one-prosthetic-segment composition.

What should the operative report document?

Document the bypass route and the graft materials and segment arrangement, including the vein segment and prosthetic segment.

Is 35681 reported per anastomosis?

No. It represents the composite graft configuration, not a count of anastomoses.

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 35681PPRRVU2026_Oct_nonQPP.csv, line 4,398 (RVU26D)

Open CMS sourceHow we calculate rates

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