No office rate
Use 35556 for the same femoral-to-popliteal route when the conduit is vein; 35656 is for a non-vein graft.
On this page
CMS RVU26D · Effective 2026-10-01
35656 Arterial bypass Medicare reimbursement rates in Delaware
Reports a lower-extremity arterial bypass using a non-vein graft to route blood from a femoral artery to a popliteal artery around obstructive disease. Compare 35656 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 35656 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
$956.56
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 35656: Femoral-to-popliteal bypass with non-vein graft
Reports a lower-extremity arterial bypass using a non-vein graft to route blood from a femoral artery to a popliteal artery around obstructive disease.
A vascular surgeon creates a route from a femoral artery to a popliteal artery using a graft other than vein, commonly a prosthetic conduit, to bypass an obstructed arterial segment. The operation is generally performed in a hospital operating room for lower-extremity arterial disease when revascularization is needed. The operative report should identify the inflow and popliteal target, the non-vein conduit, the side treated, and the bypass performed.
Choose this code for the femoral-to-popliteal route with a non-vein graft; a vein conduit or a more distal tibial or peroneal target points to a different 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 the same session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons are paid only with supporting documentation, and team surgery is not permitted.
CMS billing rules for 35656
- 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 RVU19.96 · 69%
- Practice expense (office) RVU4.07 · 14%
- Malpractice RVU5.07 · 17%
3.9K
Medicare services in 2024 · #2017 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.
35656 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
Both use a non-vein graft, but 35666 reaches an anterior tibial, posterior tibial, or peroneal artery rather than the popliteal artery.
No office rate
35671 describes a popliteal-to-tibial or peroneal bypass; 35656 begins at the femoral artery and ends at the popliteal artery.
No office rate
35661 connects femoral arteries, typically across the pelvis; 35656 connects a femoral artery to a popliteal artery.
Compare 35656 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
$956.56
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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 35656 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
4,392
- Code
- 35656
- Physician work
- 19.96
- Practice expense
- 4.07
- Malpractice
- 5.07
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 19.96 | × 1.005 | 20.0598 |
| Practice expense | 4.07 | × 0.988 | 4.0212 |
| Malpractice | 5.07 | × 0.899 | 4.5579 |
| Total RVUs | 28.6389 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$956.56
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 19.96 | 1.005 |
| Practice expense | 4.07 | 0.988 |
| Malpractice | 5.07 | 0.899 |
(19.96 × 1.005 + 4.07 × 0.988 + 5.07 × 0.899) × $33.4009 = $956.56
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.
35656 billing questions
How does this differ from 35556?
Both describe a femoral-to-popliteal bypass, but 35656 is for a non-vein graft. Use 35556 when the bypass uses a vein graft.
Does the distal target determine whether this code applies?
Yes. The target must be a popliteal artery. A bypass extending to an anterior tibial, posterior tibial, or peroneal artery is represented by a different code.
What documentation supports reporting 35656?
The operative report should establish the femoral inflow, popliteal outflow, use of a non-vein graft, and the side or sides treated.
How is bilateral surgery handled?
CMS lists bilateral reporting with modifier 50, paid at 150%. The operative documentation should support bypasses on both sides.
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?
An assistant at surgery may be paid. Co-surgeons are paid only when supporting documentation is provided.
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.
4,38935647,,Bpg aortofemoral,A,,28.99,4.28,NA,4.28,,7.42,40.69,40.69,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,39035650,,Bpg axillary-axillary,A,,19.66,3.20,NA,3.20,,5.02,27.88,27.88,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,39135654,,Bpg axillary-femoral-femoral,A,,25.62,4.88,NA,4.88,,6.52,37.02,37.02,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,39235656,,Bpg femoral-popliteal,A,,19.96,4.07,NA,4.07,,5.07,29.10,29.10,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,39335661,,Bpg femoral-femoral,A,,19.84,4.53,NA,4.53,,5.04,29.41,29.41,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,39435663,,Bpg ilioiliac,A,,23.33,3.93,NA,3.93,,5.97,33.23,33.23,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,39535665,,Bpg iliofemoral,A,,21.79,4.62,NA,4.62,,5.51,31.92,31.92,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,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