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CMS RVU26D · Effective 2026-10-01

35558 Arterial bypass Medicare reimbursement rates in Tennessee

Reports open arterial revascularization connecting the femoral arteries with a vein conduit, typically to route blood around an obstructed iliac inflow pathway. Compare 35558 office and facility rates across CMS payment localities in Tennessee.

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 35558 in Tennessee?

Tennessee 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

$1000.80

1 of 1 localities have a supported rate.

Payment area: Tennessee

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.

Find 35558 in your payment locality →

Vascular surgery

About 35558: Femoral-femoral vein bypass

Reports open arterial revascularization connecting the femoral arteries with a vein conduit, typically to route blood around an obstructed iliac inflow pathway.

A vascular surgeon creates a bypass between the femoral arteries using a vein conduit, routing blood from the better-perfused side to the opposite leg. The operation is generally performed in a hospital operating room for selected patients with lower-extremity ischemia from aortoiliac or iliac occlusive disease. The operative report should identify the donor and recipient arteries, the vein conduit, and the bypass configuration; a prosthetic graft is coded differently.

Report 35558 for the femoral-to-femoral route when a vein graft is used, not for a prosthetic fem-fem bypass. The CMS global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 bilateral reporting is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

CMS billing rules for 35558

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 RVU22.55 · 68%
  • Practice expense (office) RVU4.80 · 15%
  • Malpractice RVU5.68 · 17%

137

Medicare services in 2024 · #4621 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.

35558 compared with similar codes

Office rates for Tennessee, from the same CMS release.

35661

Femoral bypass

Femoral-to-femoral, nonvein graft

No office rate

Both describe a femoral-femoral bypass, but 35558 uses a vein conduit and 35661 uses a conduit other than vein.

35556

Arterial bypass

Vein graft, femoral to popliteal

No office rate

Both are vein-graft arterial bypass procedures; 35556 routes between the femoral and popliteal arteries, while 35558 connects the femoral arteries.

35533

Arterial bypass

Vein graft, axillary-femoral-femoral

No office rate

35533 describes an axillary-to-femoral-to-femoral bypass configuration. Use 35558 for the femoral-to-femoral route when the documented conduit is vein.

Compare 35558 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

Office and facility base rates · shared scale starting at $0

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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 35558 in Tennessee.

PPRRVU2026_Oct_nonQPP.csv

4,358

Code
35558
Physician work
22.55
Practice expense
4.80
Malpractice
5.68

GPCI2026.csv

95

Locality
Tennessee
Physician work
1.000
Practice expense
0.909
Malpractice
0.537
Facility calculation for 35558 in Tennessee
ComponentRVULocality factorAdjusted
Physician work22.55× 1.00022.5500
Practice expense4.80× 0.9094.3632
Malpractice5.68× 0.5373.0502
Total RVUs29.9634
Conversion factor× 33.4009

Facility rate, Tennessee$1000.80

Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work22.551
Practice expense4.80.909
Malpractice5.680.537

(22.55 × 1 + 4.8 × 0.909 + 5.68 × 0.537) × $33.4009 = $1000.80

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.

35558 billing questions

How is 35558 distinguished from a prosthetic fem-fem bypass?

35558 is for the femoral-to-femoral bypass using a vein conduit. A bypass using a non-vein conduit is represented by 35661.

What operative details support reporting 35558?

Document the femoral donor and recipient arteries, the bypass route, and use of a vein conduit. The record should make clear that the graft connects the femoral arteries.

Does the 90-day global period include routine postoperative care?

Yes. The day-before preoperative visit and 90 days of related postoperative care are included in the global period.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures performed in that session receive 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.

How is bilateral reporting handled?

When the service is appropriately reported as bilateral with modifier 50, CMS pays it at 150%.

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.

RVUs for 35558PPRRVU2026_Oct_nonQPP.csv, line 4,358 (RVU26D)
Geographic factors for TennesseeGPCI2026.csv, line 95 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet