No office rate
This composite graft code specifies prosthetic material combined with vein; 35683 identifies a graft made from three or more segments.
On this page
CMS RVU26D · Effective 2026-10-01
35683 Composite bypass graft Medicare reimbursement rates in Hawaii
Report this add-on when an arterial bypass uses a composite graft constructed from three or more segments, alongside the primary bypass procedure. Compare 35683 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 35683 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
$342.43
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.
Vascular surgery
About 35683: Composite bypass graft, three or more segments
Report this add-on when an arterial bypass uses a composite graft constructed from three or more segments, alongside the primary bypass procedure.
This add-on describes the graft construction used during an arterial bypass when the composite graft comprises three or more segments. A vascular surgeon typically performs the bypass in an operating room, using the graft to route blood around an obstructed or diseased artery. The primary bypass code identifies the bypass procedure and its anatomic route; this code identifies the qualifying composite graft configuration.
Report it only with a primary bypass procedure, not as a stand-alone service. The operative report should support the bypass performed and document the graft construction, including the number of segments used. For example, a femoral-to-popliteal or femoral-to-tibial bypass may have a composite graft configuration; select the primary code for the documented route and use this add-on when the graft has three or more segments. CMS pays it within the primary procedure's global period.
CMS billing rules for 35683
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU8.28 · 75%
- Practice expense (office) RVU0.66 · 6%
- Malpractice RVU2.11 · 19%
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.
35683 compared with similar codes
Office rates for Hawaii, from the same CMS release.
No office rate
This code describes a composite graft using two veins. Use 35683 for the three-or-more-segment category.
No office rate
35656 identifies a femoral-popliteal bypass using a non-vein graft; 35683 is an add-on for qualifying composite graft construction, not a bypass-route code.
No office rate
35666 identifies a femoral-to-tibial or peroneal bypass using a non-vein graft; 35683 describes the qualifying composite graft configuration.
Compare 35683 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
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$342.43
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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 35683 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
4,400
- Code
- 35683
- Physician work
- 8.28
- Practice expense
- 0.66
- Malpractice
- 2.11
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.28 | × 1.000 | 8.2800 |
| Practice expense | 0.66 | × 1.137 | 0.7504 |
| Malpractice | 2.11 | × 0.579 | 1.2217 |
| Total RVUs | 10.2521 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$342.43
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.28 | 1 |
| Practice expense | 0.66 | 1.137 |
| Malpractice | 2.11 | 0.579 |
(8.28 × 1 + 0.66 × 1.137 + 2.11 × 0.579) × $33.4009 = $342.43
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.
35683 billing questions
Can 35683 be billed by itself?
No. It is an add-on code and must be reported with a primary bypass procedure.
How is 35683 different from 35682?
35683 is the composite graft category for three or more segments; 35682 describes a composite graft using two veins.
What should the operative report document?
Document the bypass route and the graft construction, including the number of segments supporting selection of the three-or-more-segment category.
Is this code reported once for each graft segment?
It identifies the three-or-more-segment composite graft category; it is not a per-segment code.
Which code identifies the bypass route?
The primary bypass code identifies the route, such as femoral-to-popliteal or femoral-to-tibial. Report 35683 as the add-on when the graft configuration meets its segment criterion.
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.
4,39735671,,Bpg pop-tibl/-prnl artery,A,,20.25,5.39,NA,5.39,,5.16,30.80,30.80,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,39835681,,Composite byp grft pros&vein,A,,1.56,0.19,NA,0.19,,0.40,2.15,2.15,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,39935682,,Composite byp grft 2 veins,A,,7.01,0.65,NA,0.65,,1.78,9.44,9.44,0,ZZZ,0.00,0.00,0.00,0,0,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,40035683,,Composite byp grft 3/> segmt,A,,8.28,0.66,NA,0.66,,2.11,11.05,11.05,0,ZZZ,0.00,0.00,0.00,0,0,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,40135685,,Bypass graft patency/patch,A,,3.94,0.39,NA,0.39,,1.02,5.35,5.35,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,40235686,,Bypass graft/av fist patency,A,,3.26,0.26,NA,0.26,,0.83,4.35,4.35,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,40335691,,Art trnsposj vertbrl carotid,A,,17.95,3.31,NA,3.31,,4.58,25.84,25.84,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014