No office rate
Choose 35681 when the composite conduit combines prosthetic material and vein. Choose 35682 when it is constructed from two vein segments.
On this page
CMS RVU26D · Effective 2026-10-01
35682 Composite bypass Medicare reimbursement rates in North Dakota
Reports a composite arterial bypass conduit assembled from two vein segments, in addition to the primary bypass procedure describing the route. Compare 35682 office and facility rates across CMS payment localities in North Dakota.
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 35682 in North Dakota?
North Dakota 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
$279.99
1 of 1 localities have a supported rate.
Payment area: North Dakota**
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 35682: Composite arterial bypass with two vein segments
Reports a composite arterial bypass conduit assembled from two vein segments, in addition to the primary bypass procedure describing the route.
A vascular surgeon uses this add-on when a single arterial bypass conduit is assembled from two vein segments. The primary bypass code identifies the artery-to-artery route, such as a femoral-to-popliteal or femoral-to-distal-leg bypass; this code identifies the two-segment vein construction. It may be relevant when a suitable length of vein is not available as one continuous segment. The work is part of an operative revascularization, commonly for arterial occlusive disease.
Report 35682 with the primary bypass procedure for the route, not by itself. The operative report should support that the bypass used a composite conduit made from exactly two vein segments and identify the bypass route and conduit used. CMS treats this as an add-on code and pays it within the primary procedure's global period. Select the related composite-graft code according to the conduit composition and number of vein segments, rather than treating this as a general code for vein-graft bypasses.
CMS billing rules for 35682
- 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 RVU7.01 · 74%
- Practice expense (office) RVU0.65 · 7%
- Malpractice RVU1.78 · 19%
84
Medicare services in 2024 · #5006 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.
35682 compared with similar codes
Office rates for North Dakota, from the same CMS release.
No office rate
Both describe composite vein bypass construction; 35682 is for two vein segments, while 35683 is for three or more.
No office rate
35656 describes the femoral-popliteal bypass route. 35682 describes the two-segment composite vein conduit and is reported with a primary bypass procedure.
Compare 35682 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
North Dakota** →
Office / nonfacility
Unavailable
Facility
$279.99
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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 35682 in North Dakota**.
PPRRVU2026_Oct_nonQPP.csv
4,399
- Code
- 35682
- Physician work
- 7.01
- Practice expense
- 0.65
- Malpractice
- 1.78
GPCI2026.csv
84
- Locality
- North Dakota**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.406
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.01 | × 1.000 | 7.0100 |
| Practice expense | 0.65 | × 1.000 | 0.6500 |
| Malpractice | 1.78 | × 0.406 | 0.7227 |
| Total RVUs | 8.3827 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, North Dakota**$279.99
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.01 | 1 |
| Practice expense | 0.65 | 1 |
| Malpractice | 1.78 | 0.406 |
(7.01 × 1 + 0.65 × 1 + 1.78 × 0.406) × $33.4009 = $279.99
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.
35682 billing questions
When should 35682 be selected instead of 35683?
Use 35682 when the composite bypass conduit uses two vein segments. The related code 35683 is for three or more segments.
Can 35682 be reported without a primary bypass code?
No. It is an add-on code and must be reported with the primary procedure that describes the bypass route.
What documentation supports reporting 35682?
The operative report should identify the bypass route and document that the composite conduit was constructed from two vein segments.
Is 35682 reported once for each vein segment?
The code identifies a composite conduit made from two vein segments; it is not a per-segment code.
How does 35682 differ from 35681?
35682 describes a composite conduit made from two vein segments. 35681 is the related option for a composite conduit using prosthetic material and vein.
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.
4,39635666,,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
4,40235686,,Bypass graft/av fist patency,A,,3.26,0.26,NA,0.26,,0.83,4.35,4.35,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8113292,NY,04,QUEENS,1.064,1.182,1.442
8213282,NY,99,REST OF NEW YORK,1.000,0.950,0.703
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744