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Billing code 35533: Arterial bypassMedicare rate & RVUs

Reports an axillary-to-bilateral femoral arterial bypass using a vein graft, often to restore lower-extremity blood flow when aortic reconstruction is unsuitable.

CMS RVU26DEffective Oct 1, 2026109 payment localities17 Medicare services in 2024

Medicare pays $1,369.77 for 35533 nationally in a facility.

Medicare rate · 35533

Arterial bypass

Swap in your local Medicare rate.

Work RVUs
29.17
Total RVUs
41.01
Global days
090

National rate · 2026

$1,369.77

Facility setting, before claim adjustments.

See every locality for 35533 → · 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.

On this page 10 sections
  1. Medicare rate
  2. What 35533 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 35533 covers

Code 35533 describes an extra-anatomic bypass that carries blood from an axillary artery to a femoral artery and across to the opposite femoral artery, using a vein graft. Vascular surgeons may perform this reconstruction for severe aortoiliac occlusive disease when direct aortic reconstruction is not appropriate. The operative report should establish the axillary inflow, both femoral targets, and vein conduit used.

Select this code for the complete axillary-femoral-femoral route, rather than a single axillary-femoral bypass or a femoral-femoral bypass alone. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures at 50%. When bilateral reporting with modifier 50 is appropriate, CMS pays at 150%. Assistant-at-surgery services 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.

Where 35533 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

35533 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,243.45
Alaska*Unavailable$1,754.73
ArizonaUnavailable$1,329.39
ArkansasUnavailable$1,228.41
AtlantaUnavailable$1,425.06
AustinUnavailable$1,351.86
BakersfieldUnavailable$1,305.06
Baltimore/Surr. CntysUnavailable$1,455.04
BeaumontUnavailable$1,338.91
BrazoriaUnavailable$1,321.50

35533 rates by state

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

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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
35533 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 35533 rate is calculated

Each of 35533’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 · 35533

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 29.17Practice expense 4.39Malpractice 7.45

41.0100 adjusted RVUs×$33.4009 conversion factor=$1,369.77

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 35533

35533 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 35533

Arterial bypass

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 · 35533

Arterial bypass

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

35533 without 50 · national facility

$1,369.77

Arterial bypass

35533-50 · Bilateral: 150%

$2,054.66

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

35533 compared with similar codes

Compare codes

35533 vs 35521 vs 35558 vs 35633 vs 35621: national Medicare rates

Swap in your local Medicare rate.

  • 35533
    Arterial bypass · 29.17 wRVU
    —
  • 35521
    Arterial bypass · 23.53 wRVU
    —
  • 35558
    Arterial bypass · 22.55 wRVU
    —
  • 35633
    Arterial bypass · 38.13 wRVU
    —
  • 35621
    Arterial bypass · 20.5 wRVU
    —

How to choose

35521Arterial bypass
Use 35521 for an axillary-to-femoral bypass with one femoral target. 35533 includes the additional crossover to the opposite femoral artery.
35558Arterial bypass
35558 describes a femoral-femoral vein-graft bypass without axillary inflow. Choose 35533 when the bypass originates at the axillary artery and supplies both femoral arteries.
35633Arterial bypass
The route is the same, but 35633 is for a graft made from material other than vein; 35533 is the vein-graft code.
35621Arterial bypass
35621 describes an other-than-vein axillary-to-single-femoral bypass. It differs from 35533 in both conduit type and the second femoral target.

Codes related to 35533

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

Codes related to 35533
CodeHow it relatesNational office range
Same family
35521Arterial bypassVein-graft bypass from the axillary artery to one femoral target.No office rate
35558Arterial bypassVein-graft femoral-femoral bypass without the axillary inflow route.No office rate
Used instead
35633Arterial bypassSame axillary-femoral-femoral route using a conduit other than vein.No office rate
35621Arterial bypassOther-than-vein graft for a single axillary-to-femoral bypass.No office rate

35533 billing questions

How does 35533 differ from 35521?

35533 covers an axillary inflow with a bypass continuing to both femoral arteries. 35521 describes an axillary-to-femoral bypass with a single femoral target.

Does the code describe a vein graft?

Yes. The bypass uses a vein conduit; the operative report should identify the conduit and the full bypass route.

Is 35533 the right code for a femoral-femoral bypass alone?

No. A femoral-femoral bypass without the axillary inflow is a different route; 35558 is the related vein-graft code to compare.

What should the operative report document?

Document the axillary artery used for inflow, both femoral anastomosis sites, and the vein conduit. These details distinguish the full route from a single-limb bypass.

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?

Assistant-at-surgery services may be paid. Co-surgeons are paid only with 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
RVUs for 35533PPRRVU2026_Oct_nonQPP.csv, line 4,350 (RVU26D)

Open CMS sourceHow we calculate rates

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