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CMS RVU26D · Effective 2026-10-01

35583 Vein bypass Medicare reimbursement rates in Hawaii

Reports an in-situ autologous vein bypass from the femoral artery to the popliteal artery for lower-extremity arterial disease. Compare 35583 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 35583 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

$1228.10

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 35583 in your payment locality →

Vascular surgery

About 35583: In-situ femoral-popliteal vein bypass

Reports an in-situ autologous vein bypass from the femoral artery to the popliteal artery for lower-extremity arterial disease.

A vascular surgeon uses this procedure to bypass an obstructed or severely diseased artery in the leg, routing blood from the femoral artery to the popliteal artery through the patient’s vein left in its native position. The great saphenous vein is a typical conduit. The surgeon prepares the vein for arterial flow, including disrupting its valves and addressing side branches, and connects it to the arterial inflow and popliteal outflow. These bypasses are generally performed in a hospital operating room for limb ischemia or other significant lower-extremity arterial insufficiency.

Select this code when the operative report documents an in-situ vein conduit and a popliteal target; a bypass using a harvested, repositioned vein or a different conduit follows a different code pathway. Documentation should identify the conduit, bypass endpoints, and in-situ technique. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care for 90 days. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures at 50%. Modifier 50 payment for a bilateral procedure is 150%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

CMS billing rules for 35583

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 RVU27.06 · 69%
  • Practice expense (office) RVU5.03 · 13%
  • Malpractice RVU6.89 · 18%

555

Medicare services in 2024 · #3464 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.

35583 compared with similar codes

Office rates for Hawaii, from the same CMS release.

35556

Arterial bypass

Vein graft, femoral to popliteal

No office rate

Both address a femoral-to-popliteal vein bypass, but this code identifies an in-situ conduit. Choose 35556 when the documented bypass technique is not in situ.

35585

Vein bypass

Femoral to tibial or peroneal

No office rate

Both describe in-situ vein bypasses, but 35585 has tibial or peroneal outflow rather than a popliteal target.

35656

Arterial bypass

Femoral to popliteal, non-vein

No office rate

This code describes an in-situ vein bypass; 35656 is the femoral-popliteal bypass pathway for a conduit other than vein.

Compare 35583 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 35583 in Hawaii, Guam.

PPRRVU2026_Oct_nonQPP.csv

4,367

Code
35583
Physician work
27.06
Practice expense
5.03
Malpractice
6.89

GPCI2026.csv

46

Locality
Hawaii, Guam
Physician work
1.000
Practice expense
1.137
Malpractice
0.579
Facility calculation for 35583 in Hawaii, Guam
ComponentRVULocality factorAdjusted
Physician work27.06× 1.00027.0600
Practice expense5.03× 1.1375.7191
Malpractice6.89× 0.5793.9893
Total RVUs36.7684
Conversion factor× 33.4009

Facility rate, Hawaii, Guam$1228.10

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
Work27.061
Practice expense5.031.137
Malpractice6.890.579

(27.06 × 1 + 5.03 × 1.137 + 6.89 × 0.579) × $33.4009 = $1228.10

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.

35583 billing questions

How is this different from 35556?

This code is for an in-situ vein bypass to the popliteal artery. Code 35556 is the related femoral-popliteal vein bypass option when the operative technique is not in situ.

What documentation supports the in-situ technique?

The operative report should identify the vein conduit as remaining in its native position and describe the femoral inflow, popliteal outflow, and preparation of the vein for arterial flow.

Are related postoperative visits included?

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

How is this code handled with other procedures in the same session?

CMS pays the highest-valued procedure in full and other procedures at 50% under the standard multiple-procedure reduction.

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.

How is a bilateral procedure paid?

When the bilateral procedure is reported with modifier 50, CMS payment is 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 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 35583PPRRVU2026_Oct_nonQPP.csv, line 4,367 (RVU26D)
Geographic factors for Hawaii, GuamGPCI2026.csv, line 46 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet