No office rate
Use 35661 for a femoral-to-femoral bypass with femoral inflow. This code describes axillary inflow supplying both femoral arteries.
On this page
CMS RVU26D · Effective 2026-10-01
35654 Arterial bypass Medicare reimbursement rates in Kansas
Reports a non-vein bypass carrying blood from an axillary artery to both femoral arteries, typically for lower-extremity revascularization when aortic inflow is unsuitable. Compare 35654 office and facility rates across CMS payment localities in Kansas.
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 35654 in Kansas?
Kansas 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
$1112.84
1 of 1 localities have a supported rate.
Payment area: Kansas
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 35654: Axillary-to-bilateral femoral bypass
Reports a non-vein bypass carrying blood from an axillary artery to both femoral arteries, typically for lower-extremity revascularization when aortic inflow is unsuitable.
A vascular surgeon creates an extra-anatomic bypass from an axillary artery to one femoral artery, with a crossover connection supplying the opposite femoral artery. The procedure uses a conduit other than vein, commonly a synthetic graft, to restore lower-extremity blood flow. It is typically performed in a hospital operating room for severe aortoiliac occlusive disease when direct aortic reconstruction is unsuitable or carries excessive risk.
Report this code when the operative record supports the axillary inflow, both femoral outflow connections, and use of a non-vein graft. The record should identify the indication, graft route and configuration, and the vessels treated. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. Modifier 50 is inappropriate for this already bilateral configuration. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 35654
- 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- 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 RVU25.62 · 69%
- Practice expense (office) RVU4.88 · 13%
- Malpractice RVU6.52 · 18%
647
Medicare services in 2024 · #3334 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.
35654 compared with similar codes
Office rates for Kansas, from the same CMS release.
No office rate
Use 35646 for an aortobifemoral bypass with aortic inflow. This code describes an extra-anatomic route from the axillary artery.
No office rate
Use 35623 when the axillary bypass outflow is to a popliteal or tibial artery, rather than to both femoral arteries.
Compare 35654 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
Kansas →
Office / nonfacility
Unavailable
Facility
$1112.84
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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 35654 in Kansas.
PPRRVU2026_Oct_nonQPP.csv
4,391
- Code
- 35654
- Physician work
- 25.62
- Practice expense
- 4.88
- Malpractice
- 6.52
GPCI2026.csv
54
- Locality
- Kansas
- Physician work
- 1.000
- Practice expense
- 0.904
- Malpractice
- 0.504
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 25.62 | × 1.000 | 25.6200 |
| Practice expense | 4.88 | × 0.904 | 4.4115 |
| Malpractice | 6.52 | × 0.504 | 3.2861 |
| Total RVUs | 33.3176 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kansas$1112.84
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 25.62 | 1 |
| Practice expense | 4.88 | 0.904 |
| Malpractice | 6.52 | 0.504 |
(25.62 × 1 + 4.88 × 0.904 + 6.52 × 0.504) × $33.4009 = $1112.84
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.
35654 billing questions
How does this differ from 35661?
This procedure uses axillary inflow and supplies both femoral arteries. Code 35661 describes a femoral-to-femoral bypass, with inflow from a femoral artery.
Should modifier 50 be appended?
No. The axillary-to-femoral-femoral configuration already describes bypass to both femoral arteries, and bilateral adjustment is inappropriate.
What should the operative report document?
Document the axillary inflow, each femoral connection, the graft configuration and conduit type, and the clinical indication for revascularization.
How does the global period affect postoperative visits?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can this be reported with another procedure performed in the same session?
When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction.
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.
4,38835646,,Bpg aortobifemoral,A,,32.16,5.87,NA,5.87,,8.17,46.20,46.20,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,38935647,,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
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
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958