Billing code 35656: Arterial bypassMedicare rate & RVUs in Maine
Reports a lower-extremity arterial bypass using a non-vein graft to route blood from a femoral artery to a popliteal artery around obstructive disease.
CMS doesn’t publish an office rate for 35656 in Maine.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 35656 covers
A vascular surgeon creates a route from a femoral artery to a popliteal artery using a graft other than vein, commonly a prosthetic conduit, to bypass an obstructed arterial segment. The operation is generally performed in a hospital operating room for lower-extremity arterial disease when revascularization is needed. The operative report should identify the inflow and popliteal target, the non-vein conduit, the side treated, and the bypass performed.
Choose this code for the femoral-to-popliteal route with a non-vein graft; a vein conduit or a more distal tibial or peroneal target points to a different 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 the same session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons are paid only with supporting documentation, and team surgery is not permitted.
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.
Where 35656 pays more and less in Maine
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Maine | Unavailable | $897.08 |
| Southern Maine | Unavailable | $908.26 |
How the 35656 rate is calculated
Each of 35656’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 35656
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 19.96Practice expense 4.07Malpractice 5.07
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 35656
35656 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 35656
Arterial bypass
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.84/0.07 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 35656
Arterial bypass
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
35656 without 50 · national facility
$971.97
Arterial bypass
35656-50 · Bilateral: 150%
$1,457.96
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
35656 compared with similar codes
Compare codes
35656 vs 35556 vs 35666 vs 35671 vs 35661: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 35556Arterial bypass
- Use 35556 for the same femoral-to-popliteal route when the conduit is vein; 35656 is for a non-vein graft.
- 35666Leg bypass
- Both use a non-vein graft, but 35666 reaches an anterior tibial, posterior tibial, or peroneal artery rather than the popliteal artery.
- 35671Leg bypass
- 35671 describes a popliteal-to-tibial or peroneal bypass; 35656 begins at the femoral artery and ends at the popliteal artery.
- 35661Femoral bypass
- 35661 connects femoral arteries, typically across the pelvis; 35656 connects a femoral artery to a popliteal artery.
35656 billing questions
How does this differ from 35556?
Both describe a femoral-to-popliteal bypass, but 35656 is for a non-vein graft. Use 35556 when the bypass uses a vein graft.
Does the distal target determine whether this code applies?
Yes. The target must be a popliteal artery. A bypass extending to an anterior tibial, posterior tibial, or peroneal artery is represented by a different code.
What documentation supports reporting 35656?
The operative report should establish the femoral inflow, popliteal outflow, use of a non-vein graft, and the side or sides treated.
How is bilateral surgery handled?
CMS lists bilateral reporting with modifier 50, paid at 150%. The operative documentation should support bypasses on both sides.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only when supporting documentation is provided.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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