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CMS RVU26D · Effective 2026-10-01

35539 Aortic bypass Medicare reimbursement rates in Hawaii

Reports an aorta-to-one-femoral-artery bypass using a vein conduit, typically to restore lower-extremity blood flow in aortoiliac occlusive disease. Compare 35539 office and facility rates across CMS payment localities in Hawaii.

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 35539 in Hawaii?

Hawaii 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

$1859.13

1 of 1 localities have a supported rate.

Payment area: Hawaii, Guam

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.

Find 35539 in your payment locality →

Vascular surgery

About 35539: Aortic-to-femoral vein bypass

Reports an aorta-to-one-femoral-artery bypass using a vein conduit, typically to restore lower-extremity blood flow in aortoiliac occlusive disease.

A vascular surgeon routes a vein graft from the aorta to a femoral artery to bypass obstructed inflow and improve blood supply to one lower extremity. The operation is generally performed in a hospital operating room for significant aortoiliac occlusive disease, such as ischemia associated with rest pain or tissue loss. The operative report should establish the aortic origin, the single femoral outflow target, and use of a vein conduit.

Select this code when the documented reconstruction has one femoral target; an aortic reconstruction with two femoral outflows is distinguished by code 35540. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during the following 90 days. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures at 50%. CMS lists bilateral reporting with modifier 50 at 150%. Assistant-at-surgery payment may be allowed; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

CMS billing rules for 35539

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 RVU43.01 · 72%
  • Practice expense (office) RVU5.52 · 9%
  • Malpractice RVU11.01 · 18%

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.

35539 compared with similar codes

Office rates for Hawaii, from the same CMS release.

35540

Aortic bypass

Autogenous vein conduit

No office rate

Use 35540 when the aortic reconstruction supplies both femoral arteries. Code 35539 describes a single femoral outflow target.

35537

Aortoiliac bypass

Vein conduit, iliac outflow

No office rate

35537 ends at an iliac artery; 35539 ends at a femoral artery. Follow the documented distal target.

35538

Aortic bypass

Aorta to both iliac arteries

No office rate

35538 supplies both iliac arteries from the aorta. It is distinct from the single femoral outflow described by 35539.

35521

Arterial bypass

Axillary-to-femoral, vein conduit

No office rate

35521 uses axillary inflow for a femoral target, rather than the aortic inflow used for 35539.

Compare 35539 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

Office and facility base rates · shared scale starting at $0

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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 35539 in Hawaii, Guam.

PPRRVU2026_Oct_nonQPP.csv

4,355

Code
35539
Physician work
43.01
Practice expense
5.52
Malpractice
11.01

GPCI2026.csv

46

Locality
Hawaii, Guam
Physician work
1.000
Practice expense
1.137
Malpractice
0.579
Facility calculation for 35539 in Hawaii, Guam
ComponentRVULocality factorAdjusted
Physician work43.01× 1.00043.0100
Practice expense5.52× 1.1376.2762
Malpractice11.01× 0.5796.3748
Total RVUs55.6610
Conversion factor× 33.4009

Facility rate, Hawaii, Guam$1859.13

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.
Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work43.011
Practice expense5.521.137
Malpractice11.010.579

(43.01 × 1 + 5.52 × 1.137 + 11.01 × 0.579) × $33.4009 = $1859.13

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.

35539 billing questions

How does 35539 differ from 35540?

35539 describes a vein bypass from the aorta to one femoral artery. Use 35540 for an aortic reconstruction with right and left femoral outflows.

What operative details support 35539?

The operative report should identify the aortic inflow, the single femoral artery receiving flow, and the vein conduit. It should also document the indication for the reconstruction.

Does the 90-day global period include postoperative care?

Yes. CMS includes the day-before preoperative visit and 90 days of related postoperative care in the major-surgery global period.

How are other procedures in the same session paid?

CMS pays the highest-valued procedure in full and other procedures at 50% when they are performed in the same session.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be allowed. Co-surgeon payment requires supporting documentation; CMS does not permit team surgery.

When is modifier 50 relevant?

CMS lists bilateral reporting with modifier 50 at 150%. For an aortic reconstruction with two femoral outflows, compare the documented operation with the specific sibling code 35540.

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.

RVUs for 35539PPRRVU2026_Oct_nonQPP.csv, line 4,355 (RVU26D)
Geographic factors for Hawaii, GuamGPCI2026.csv, line 46 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet