No office rate
Both codes describe a femoral-femoral bypass route using a nonvein graft. Choose 35654 when the graft’s inflow is axillary rather than femoral.
On this page
CMS RVU26D · Effective 2026-10-01
35661 Femoral bypass Medicare reimbursement rates in Oregon
Reports a nonvein crossover graft between femoral arteries to restore blood flow to a leg affected by inadequate arterial inflow. Compare 35661 office and facility rates across CMS payment localities in Oregon.
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 35661 in Oregon?
Oregon has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$931.72–$966.62
2 of 2 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.
Vascular surgery
About 35661: Prosthetic femoral-to-femoral bypass
Reports a nonvein crossover graft between femoral arteries to restore blood flow to a leg affected by inadequate arterial inflow.
This operation creates an extra-anatomic crossover graft between the femoral arteries, routing blood from a patent donor-side artery to the opposite leg when native inflow is inadequate. It is commonly performed for unilateral iliac or aortoiliac occlusive disease when a femoral artery can supply the ischemic limb. The code represents a conduit other than vein, commonly prosthetic, placed by a vascular surgeon in an operating room; it is not a femoral-to-popliteal bypass.
The operative report should identify the inflow and outflow arteries, the anastomosis sites, conduit type, indication, and any additional distinct procedures. The 90-day global period includes 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 others are subject to the standard multiple procedure reduction. CMS classifies this as bilateral: modifier 50 is paid at 150% for a qualifying bilateral service, but the crossover’s connection between both groins alone does not establish a bilateral service. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 35661
- 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 procedure with modifier 50 is paid at 150%.
- 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 RVU19.84 · 67%
- Practice expense (office) RVU4.53 · 15%
- Malpractice RVU5.04 · 17%
2.1K
Medicare services in 2024 · #2432 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.
35661 compared with similar codes
Office rates for Oregon, from the same CMS release.
No office rate
35646 describes aortobifemoral bypass, with aortic inflow and bilateral femoral outflow. This code describes a femoral-to-femoral crossover.
No office rate
35656 is for a bypass from a femoral artery to a popliteal artery. This code has the opposite femoral artery as its outflow target.
No office rate
35665 describes an iliofemoral bypass. Use this code when the bypass runs from one femoral artery to the other.
Compare 35661 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.
2 of 2 payment localities
Portland →
Office / nonfacility
Unavailable
Facility
$966.62
Rest Of Oregon →
Office / nonfacility
Unavailable
Facility
$931.72
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35661 billing questions
Does this code describe a vein graft?
No. It describes a femoral-to-femoral bypass using a conduit other than vein, commonly a prosthetic graft.
Should modifier 50 be used because the graft connects both groins?
Not for that reason alone. The femoral-to-femoral crossover inherently involves both sides; CMS applies the bilateral payment rule when a qualifying bilateral service is reported with modifier 50.
How does this differ from a femoral-popliteal bypass?
This graft crosses from one femoral artery to the opposite femoral artery. A femoral-popliteal bypass has a popliteal artery as its distal target.
Are related postoperative visits included?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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.
4,39035650,,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
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