No office rate
Both revise a lower-extremity arterial bypass without thrombectomy. Choose 35881 for vein interposition and 35879 for patch angioplasty.
On this page
CMS RVU26D · Effective 2026-10-01
35881 Bypass revision Medicare reimbursement rates in Iowa
Reports revision of a lower-extremity arterial bypass using a vein interposition graft when the operation does not include thrombectomy. Compare 35881 office and facility rates across CMS payment localities in Iowa.
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 35881 in Iowa?
Iowa 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
$826.34
1 of 1 localities have a supported rate.
Payment area: Iowa
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 35881: Lower-extremity bypass revision with vein
Reports revision of a lower-extremity arterial bypass using a vein interposition graft when the operation does not include thrombectomy.
A vascular surgeon uses this service to revise a lower-extremity arterial bypass by replacing a portion of the graft with vein. It addresses a graft segment that needs reconstruction, rather than a procedure limited to removing clot. The operation is generally performed in a hospital or other surgical setting; the operative report should identify the bypass, the segment revised, and the vein used.
Report the code when the documented revision uses vein interposition and does not include thrombectomy. If the surgeon also removes graft clot while revising the graft, compare the combined thrombectomy-and-revision 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 one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral procedures reported with modifier 50, CMS pays 150%. Assistant-at-surgery payment may be allowed; co-surgeon payment requires supporting documentation, and team-surgery payment is not permitted.
CMS billing rules for 35881
- 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 RVU18.87 · 67%
- Practice expense (office) RVU4.35 · 16%
- Malpractice RVU4.76 · 17%
107
Medicare services in 2024 · #4828 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.
35881 compared with similar codes
Office rates for Iowa, from the same CMS release.
No office rate
35876 describes open thrombectomy performed with graft revision. Use 35881 when the revision is performed without thrombectomy.
No office rate
35883 is specific to revision of a femoral anastomosis using a nonautogenous graft; 35881 describes lower-extremity bypass revision using vein interposition.
No office rate
35884 is specific to revision of a femoral anastomosis using an autogenous vein graft. 35881 describes bypass revision using vein interposition.
Compare 35881 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
Iowa →
Office / nonfacility
Unavailable
Facility
$826.34
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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 35881 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
4,423
- Code
- 35881
- Physician work
- 18.87
- Practice expense
- 4.35
- Malpractice
- 4.76
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 18.87 | × 1.000 | 18.8700 |
| Practice expense | 4.35 | × 0.915 | 3.9802 |
| Malpractice | 4.76 | × 0.397 | 1.8897 |
| Total RVUs | 24.7400 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$826.34
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 18.87 | 1 |
| Practice expense | 4.35 | 0.915 |
| Malpractice | 4.76 | 0.397 |
(18.87 × 1 + 4.35 × 0.915 + 4.76 × 0.397) × $33.4009 = $826.34
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.
35881 billing questions
How is this different from 35879?
35881 describes bypass revision using a vein interposition graft. 35879 is the patch-angioplasty approach to lower-extremity bypass revision.
Can this be reported when the surgeon removes clot?
This code describes revision without thrombectomy. When thrombectomy and graft revision are both performed, compare 35876, which describes the combined service.
What documentation supports reporting 35881?
The operative report should identify the lower-extremity arterial bypass, the segment revised, and the use of vein as an interposition graft. It should also clarify whether thrombectomy was performed.
Are related postoperative visits included?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How does CMS handle multiple procedures in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard 50% multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be allowed. Co-surgeon payment requires supporting documentation; team-surgery payment is not permitted.
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.
4,42035875,,Removal of clot in graft,A,,10.45,3.03,NA,3.03,,2.64,16.12,16.12,0,090,0.09,0.84,0.07,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,42135876,,Removal of clot in graft,A,,17.37,3.94,NA,3.94,,4.33,25.64,25.64,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,42235879,,Revise graft w/vein,A,,16.97,3.89,NA,3.89,,4.32,25.18,25.18,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,42335881,,Revise graft w/vein,A,,18.87,4.35,NA,4.35,,4.76,27.98,27.98,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,42435883,,Revj fem anast nonautog grf,A,,22.57,4.13,NA,4.13,,5.74,32.44,32.44,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,42535884,,Revj fem anast autog vn grf,A,,24.03,3.57,NA,3.57,,6.15,33.75,33.75,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,42635901,,Excision graft neck,A,,8.17,2.89,NA,2.89,,2.08,13.14,13.14,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136