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Billing code 35881: Bypass revisionMedicare rate & RVUs

Reports revision of a lower-extremity arterial bypass using a vein interposition graft when the operation does not include thrombectomy.

CMS RVU26DEffective Oct 1, 2026109 payment localities107 Medicare services in 2024

Medicare pays $934.56 for 35881 nationally in a facility.

Medicare rate · 35881

Bypass revision

Swap in your local Medicare rate.

Work RVUs
18.87
Total RVUs
27.98
Global days
090

National rate · 2026

$934.56

Facility setting, before claim adjustments.

See every locality for 35881 → · 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 35881 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 35881 covers

A vascular surgeon uses this service to revise a lower-extremity arterial bypass by replacing a portion of the graft with vein. It addresses a graft segment that needs reconstruction, rather than a procedure limited to removing clot. The operation is generally performed in a hospital or other surgical setting; the operative report should identify the bypass, the segment revised, and the vein used.

Report the code when the documented revision uses vein interposition and does not include thrombectomy. If the surgeon also removes graft clot while revising the graft, compare the combined thrombectomy-and-revision code. CMS assigns a 90-day global period, including 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. For bilateral procedures reported with modifier 50, CMS pays 150%. Assistant-at-surgery payment may be allowed; co-surgeon payment requires supporting documentation, and team-surgery payment 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 35881 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

35881 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$847.39
Alaska*Unavailable$1,187.75
ArizonaUnavailable$907.16
ArkansasUnavailable$836.96
AtlantaUnavailable$970.73
AustinUnavailable$926.12
BakersfieldUnavailable$898.32
Baltimore/Surr. CntysUnavailable$992.93
BeaumontUnavailable$910.19
BrazoriaUnavailable$903.31

35881 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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
35881 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 35881 rate is calculated

Each of 35881’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 · 35881

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 18.87Practice expense 4.35Malpractice 4.76

27.9800 adjusted RVUs×$33.4009 conversion factor=$934.56

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

Payment rules and modifiers for 35881

35881 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 35881

Bypass revision

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 · 35881

Bypass revision

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

35881 without 50 · national facility

$934.56

Bypass revision

35881-50 · Bilateral: 150%

$1,401.84

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

35881 compared with similar codes

Compare codes

35881 vs 35879 vs 35876 vs 35883 vs 35884: national Medicare rates

Swap in your local Medicare rate.

  • 35881
    Bypass revision · 18.87 wRVU
    —
  • 35879
    Bypass revision · 16.97 wRVU
    —
  • 35876
    Graft thrombectomy · 17.37 wRVU
    —
  • 35883
    Graft revision · 22.57 wRVU
    —
  • 35884
    Graft revision · 24.03 wRVU
    —

How to choose

35879Bypass revision
Both revise a lower-extremity arterial bypass without thrombectomy. Choose 35881 for vein interposition and 35879 for patch angioplasty.
35876Graft thrombectomy
35876 describes open thrombectomy performed with graft revision. Use 35881 when the revision is performed without thrombectomy.
35883Graft revision
35883 is specific to revision of a femoral anastomosis using a nonautogenous graft; 35881 describes lower-extremity bypass revision using vein interposition.
35884Graft revision
35884 is specific to revision of a femoral anastomosis using an autogenous vein graft. 35881 describes bypass revision using vein interposition.

Codes related to 35881

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

Codes related to 35881
CodeHow it relatesNational office range
Same family
35879Bypass revisionLower-extremity bypass revision using patch angioplasty rather than vein interposition.No office rate
Used instead
35876Graft thrombectomyUse when open thrombectomy is performed with arterial or venous graft revision.No office rate
35875Graft thrombectomyGraft thrombectomy without the combined graft revision described by 35876.No office rate
35883Graft revisionFemoral anastomosis revision involving a nonautogenous graft.No office rate
35884Graft revisionFemoral anastomosis revision involving an autogenous vein graft.No office rate

35881 billing questions

How is this different from 35879?

35881 describes bypass revision using a vein interposition graft. 35879 is the patch-angioplasty approach to lower-extremity bypass revision.

Can this be reported when the surgeon removes clot?

This code describes revision without thrombectomy. When thrombectomy and graft revision are both performed, compare 35876, which describes the combined service.

What documentation supports reporting 35881?

The operative report should identify the lower-extremity arterial bypass, the segment revised, and the use of vein as an interposition graft. It should also clarify whether thrombectomy was performed.

Are related postoperative visits included?

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

How does CMS handle multiple procedures in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard 50% multiple-procedure reduction.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be allowed. Co-surgeon payment requires supporting documentation; team-surgery payment 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 35881PPRRVU2026_Oct_nonQPP.csv, line 4,423 (RVU26D)

Open CMS sourceHow we calculate rates

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