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Billing code 35558: Arterial bypassMedicare rate & RVUs

Reports open arterial revascularization connecting the femoral arteries with a vein conduit, typically to route blood around an obstructed iliac inflow pathway.

CMS RVU26DEffective Oct 1, 2026109 payment localities137 Medicare services in 2024

Medicare pays $1,103.23 for 35558 nationally in a facility.

Medicare rate · 35558

Arterial bypass

Swap in your local Medicare rate.

Work RVUs
22.55
Total RVUs
33.03
Global days
090

National rate · 2026

$1,103.23

Facility setting, before claim adjustments.

See every locality for 35558 → · 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 35558 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 35558 covers

A vascular surgeon creates a bypass between the femoral arteries using a vein conduit, routing blood from the better-perfused side to the opposite leg. The operation is generally performed in a hospital operating room for selected patients with lower-extremity ischemia from aortoiliac or iliac occlusive disease. The operative report should identify the donor and recipient arteries, the vein conduit, and the bypass configuration; a prosthetic graft is coded differently.

Report 35558 for the femoral-to-femoral route when a vein graft is used, not for a prosthetic fem-fem bypass. The CMS global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 bilateral reporting is paid at 150%. 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 35558 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

35558 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,000.85
Alaska*Unavailable$1,405.06
ArizonaUnavailable$1,070.94
ArkansasUnavailable$988.61
AtlantaUnavailable$1,146.19
AustinUnavailable$1,092.41
BakersfieldUnavailable$1,058.75
Baltimore/Surr. CntysUnavailable$1,171.95
BeaumontUnavailable$1,075.33
BrazoriaUnavailable$1,066.08

35558 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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
35558 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 35558 rate is calculated

Each of 35558’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 · 35558

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 22.55Practice expense 4.80Malpractice 5.68

33.0300 adjusted RVUs×$33.4009 conversion factor=$1,103.23

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

Payment rules and modifiers for 35558

35558 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 35558

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 · 35558

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

35558 without 50 · national facility

$1,103.23

Arterial bypass

35558-50 · Bilateral: 150%

$1,654.85

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

35558 compared with similar codes

Compare codes

35558 vs 35661 vs 35556 vs 35533: national Medicare rates

Swap in your local Medicare rate.

  • 35558
    Arterial bypass · 22.55 wRVU
    —
  • 35661
    Femoral bypass · 19.84 wRVU
    —
  • 35556
    Arterial bypass · 26.08 wRVU
    —
  • 35533
    Arterial bypass · 29.17 wRVU
    —

How to choose

35661Femoral bypass
Both describe a femoral-femoral bypass, but 35558 uses a vein conduit and 35661 uses a conduit other than vein.
35556Arterial bypass
Both are vein-graft arterial bypass procedures; 35556 routes between the femoral and popliteal arteries, while 35558 connects the femoral arteries.
35533Arterial bypass
35533 describes an axillary-to-femoral-to-femoral bypass configuration. Use 35558 for the femoral-to-femoral route when the documented conduit is vein.

Codes related to 35558

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

Codes related to 35558
CodeHow it relatesNational office range
Used instead
35661Femoral bypassFemoral-femoral bypass using a conduit other than vein.No office rate
35533Arterial bypassVein bypass configuration using axillary inflow and femoral outflow.No office rate
Same family
35556Arterial bypassVein bypass code for a femoral-to-popliteal route rather than femoral-to-femoral.No office rate

35558 billing questions

How is 35558 distinguished from a prosthetic fem-fem bypass?

35558 is for the femoral-to-femoral bypass using a vein conduit. A bypass using a non-vein conduit is represented by 35661.

What operative details support reporting 35558?

Document the femoral donor and recipient arteries, the bypass route, and use of a vein conduit. The record should make clear that the graft connects the femoral arteries.

Does the 90-day global period include routine postoperative care?

Yes. The day-before preoperative visit and 90 days of related postoperative care are included in the global period.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures performed in that session receive 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.

How is bilateral reporting handled?

When the service is appropriately reported as bilateral with modifier 50, CMS pays it at 150%.

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 35558PPRRVU2026_Oct_nonQPP.csv, line 4,358 (RVU26D)

Open CMS sourceHow we calculate rates

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