No office rate
Choose 35682 when the composite graft uses two vein segments. Choose 35681 when it uses one vein segment and one prosthetic segment.
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CMS RVU26D · Effective 2026-10-01
35681 Composite bypass graft Medicare reimbursement rates in Missouri
Reports a composite arterial bypass graft made with one vein segment and one prosthetic segment, alongside the primary code for the bypass route. Compare 35681 office and facility rates across CMS payment localities in Missouri.
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 35681 in Missouri?
Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$70.59–$71.53
3 of 3 localities have a supported rate.
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.
Where 35681 pays more and less in Missouri
Vascular surgery
About 35681: Composite prosthetic and vein bypass graft
Reports a composite arterial bypass graft made with one vein segment and one prosthetic segment, alongside the primary code for the bypass route.
A vascular surgeon may construct a composite bypass when the required conduit combines one segment of vein with one segment of prosthetic graft. This configuration can be used for an arterial bypass, such as a lower-extremity bypass, when the operative plan uses both materials to create the graft. The bypass route and recipient vessels determine the primary procedure code; this code identifies the composite graft construction.
Report 35681 only with the primary bypass procedure, not by itself. The surgeon’s operative report should identify the bypass route and document that the graft comprises one vein segment and one prosthetic segment. CMS treats this as an add-on code paid within the primary procedure’s global period. Select a different composite-graft code when the documented number or type of segments differs.
CMS billing rules for 35681
- 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 RVU1.56 · 73%
- Practice expense (office) RVU0.19 · 9%
- Malpractice RVU0.40 · 19%
165
Medicare services in 2024 · #4490 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.
35681 compared with similar codes
Office rates for Missouri, from the same CMS release.
No office rate
Choose 35683 when the composite graft contains three or more segments; 35681 describes the one-vein, one-prosthetic-segment configuration.
No office rate
35656 identifies a femoral-popliteal bypass route. Add 35681 when the documented graft for that bypass combines one vein segment and one prosthetic segment.
Compare 35681 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.
3 of 3 payment localities
Metropolitan Kansas City →
Office / nonfacility
Unavailable
Facility
$71.12
Metropolitan St. Louis →
Office / nonfacility
Unavailable
Facility
$71.53
Rest Of Missouri →
Office / nonfacility
Unavailable
Facility
$70.59
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35681 billing questions
Can 35681 be reported by itself?
No. It is an add-on code and must be reported with the primary procedure that identifies the bypass route.
When is 35681 appropriate instead of 35682?
Use 35681 for a composite graft with one vein segment and one prosthetic segment. Code 35682 describes a composite graft made with two vein segments.
Does 35681 identify the bypass route?
No. The primary bypass code identifies the route and target vessels; 35681 reports the graft’s one-vein, one-prosthetic-segment composition.
What should the operative report document?
Document the bypass route and the graft materials and segment arrangement, including the vein segment and prosthetic segment.
Is 35681 reported per anastomosis?
No. It represents the composite graft configuration, not a count of anastomoses.
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.
4,39535665,,Bpg iliofemoral,A,,21.79,4.62,NA,4.62,,5.51,31.92,31.92,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,39635666,,Bpg fem-ant tib pst tib/prnl,A,,23.07,6.00,NA,6.00,,5.89,34.96,34.96,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,39735671,,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