No office rate
35621 connects axillary inflow to a femoral artery. Choose 35654 when the configuration continues across to the opposite femoral distribution.
On this page
CMS RVU26D · Effective 2026-10-01
35621 Arterial bypass Medicare reimbursement rates in Delaware
Reports a non-vein bypass from the axillary artery to a femoral artery, typically to restore leg blood flow when aortic reconstruction is unsuitable. Compare 35621 office and facility rates across CMS payment localities in Delaware.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 35621 in Delaware?
Delaware has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$974.58
1 of 1 localities have a supported rate.
Payment area: Delaware
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Vascular surgery
About 35621: Axillary-to-femoral bypass graft
Reports a non-vein bypass from the axillary artery to a femoral artery, typically to restore leg blood flow when aortic reconstruction is unsuitable.
A vascular surgeon creates an extra-anatomic route from the axillary artery to a femoral artery using a conduit other than vein, often a synthetic graft. The graft is tunneled beneath the skin and connected to the arteries to carry blood around diseased or obstructed aortoiliac segments. This operation is generally performed in a hospital operating room for patients who need lower-extremity revascularization but are not suited to direct aortic reconstruction.
Report the code when the documented bypass connects axillary inflow to a femoral target; distinguish it from grafts extending to more distal leg arteries or crossing to the opposite femoral artery. The operative report should identify the inflow and outflow vessels, conduit, laterality, and bypass configuration. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 35621
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU20.50 · 69%
- Practice expense (office) RVU3.93 · 13%
- Malpractice RVU5.22 · 18%
397
Medicare services in 2024 · #3743 by national volume
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.
35621 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
Use 35621 when the distal anastomosis is femoral; 35623 describes an axillary bypass to a popliteal or tibial artery.
No office rate
35661 uses one femoral artery as inflow for a crossover graft to the other femoral artery. 35621 instead brings inflow from the axillary artery.
No office rate
35646 describes an aortic-to-bilateral-femoral reconstruction. 35621 uses axillary inflow for an extra-anatomic route to a femoral artery.
Compare 35621 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Delaware →
Office / nonfacility
Unavailable
Facility
$974.58
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 35621 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
4,376
- Code
- 35621
- Physician work
- 20.50
- Practice expense
- 3.93
- Malpractice
- 5.22
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 20.50 | × 1.005 | 20.6025 |
| Practice expense | 3.93 | × 0.988 | 3.8828 |
| Malpractice | 5.22 | × 0.899 | 4.6928 |
| Total RVUs | 29.1781 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$974.58
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 20.5 | 1.005 |
| Practice expense | 3.93 | 0.988 |
| Malpractice | 5.22 | 0.899 |
(20.5 × 1.005 + 3.93 × 0.988 + 5.22 × 0.899) × $33.4009 = $974.58
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
35621 billing questions
When is 35621 preferred over 35654?
Use 35621 for a bypass from the axillary artery to a femoral artery. Code 35654 describes an axillary-to-femoral-femoral configuration that also supplies the opposite femoral distribution.
How does 35621 differ from an axillary-to-popliteal bypass?
The distal target determines the distinction: 35621 ends at a femoral artery, while 35623 reaches a popliteal or tibial artery.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral performance reported?
When the bypass is performed bilaterally, modifier 50 is associated with payment at 150% under the CMS facts for this code.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What operative details support reporting 35621?
Document the axillary inflow, femoral outflow, conduit type, laterality, and bypass configuration so the route can be distinguished from other extra-anatomic grafts.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
4,37335606,,Bpg carotid-subclavian,A,,21.90,4.41,NA,4.41,,5.57,31.88,31.88,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,37435612,,Bpg subclavian-subclavian,A,,19.84,3.64,NA,3.64,,5.06,28.54,28.54,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,37535616,,Bpg subclavian-axillary,A,,21.27,3.32,NA,3.32,,5.43,30.02,30.02,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,37635621,,Bpg axillary-femoral,A,,20.50,3.93,NA,3.93,,5.22,29.65,29.65,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,37735623,,Bpg axillary-pop/-tibial,A,,25.27,4.08,NA,4.08,,6.45,35.80,35.80,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,37835626,,Bpg aor-subcla/innom/carotid,A,,28.41,8.89,NA,8.89,,7.05,44.35,44.35,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,37935631,,Bpg aor-celiac-msn-renal,A,,35.13,6.06,NA,6.06,,8.93,50.12,50.12,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503