Billing code 35685: Bypass patchMedicare rate & RVUs in Nevada
An add-on for a bypass operation when a patch angioplasty is performed to support graft patency, such as with a profunda outflow repair.
CMS doesn’t publish an office rate for 35685 in Nevada.
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 35685 covers
This add-on represents patch angioplasty performed as an adjunct to an arterial bypass to improve or maintain graft outflow and patency. A vascular surgeon may use it when the artery at the bypass outflow requires enlargement; profundaplasty is a typical example. The patch is part of the open operation, not a separate later procedure. It is generally encountered in facility-based vascular surgery, including lower-extremity revascularization for significant arterial disease.
Report 35685 only with the primary bypass procedure when the operative note supports a distinct patch angioplasty for graft patency. Documentation should identify the bypass, the artery treated, and the patch work performed; a routine anastomosis alone does not establish this service. This is an add-on code, not a standalone bypass code. Medicare pays it within the primary procedure's global period, so it is reported with that primary procedure rather than as an independent service.
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.
35685 in Nevada**
| Payment locality | Office | Facility |
|---|---|---|
| Nevada** | Unavailable | $173.02 |
How the 35685 rate is calculated
Each of 35685’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 · 35685
RVUs × geographic indexes × conversion factor
Work3.94
3.94 RVUs× 1.000 GPCI
Practice expense0.39
0.39 RVUs× 1.000 GPCI
Malpractice1.02
1.02 RVUs× 1.000 GPCI
Adjusted RVUs
5.3500
Conversion factor
$33.4009
Medicare rate
$178.69
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 35685
The CMS indicators that decide how 35685 is paid alongside other services.
CMS payment indicators · 35685
Bypass patch
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| 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. |
What modifiers do to the payment
Modifier 80 · payment effect
With and without the modifier
35685 without 80 · national facility
$178.69
Bypass patch
35685-80 · Assistant: 16%
$28.59
A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.
35685 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 35686Patency work
- Choose 35685 for patch angioplasty performed to support graft patency; 35686 describes a distal arteriovenous fistula used for that purpose.
- 35656Arterial bypass
- 35656 describes the femoral-popliteal bypass itself. 35685 is an add-on for a separate patch angioplasty performed to support patency during the bypass operation.
- 35666Leg bypass
- 35666 describes a femoral bypass to a distal leg artery; it is the primary bypass procedure, while 35685 reports an accompanying patency patch when performed.
35685 billing questions
When should 35685 be reported with a bypass?
Report it when the surgeon performs a patch angioplasty as an adjunct to the bypass to support graft patency. The operative note should describe the artery patched and the additional patch work.
Can 35685 be billed by itself?
No. It is an add-on code and must be reported with a primary bypass procedure.
How is 35685 different from 35686?
35685 represents a patch angioplasty for graft patency. 35686 represents a distal arteriovenous fistula used to support bypass patency, a different adjunct technique.
Is a patch included in the primary bypass code?
A routine bypass anastomosis does not support separate reporting of 35685. Report the add-on when documentation shows the distinct patch angioplasty performed for graft patency.
What documentation supports 35685?
The operative report should identify the bypass and the artery receiving the patch, and describe the patch angioplasty as an adjunct to maintain or improve graft patency.
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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