Billing code 35556: Arterial bypassMedicare rate & RVUs in Texas
Reports a lower-extremity arterial bypass using a vein conduit from the femoral artery to the popliteal artery to restore blood flow around an obstruction.
CMS doesn’t publish an office rate for 35556 in Texas.
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 35556 covers
A vascular surgeon uses a vein conduit to route blood from the femoral artery to the popliteal artery, bypassing an obstructed segment. The operation is commonly performed in a hospital operating room for lower-extremity arterial occlusive disease when revascularization is needed. A harvested saphenous vein is a familiar conduit example. This code distinguishes a vein-graft bypass from a bypass using a non-vein graft and from an in-situ vein bypass.
Select the code based on the documented conduit, bypass endpoints, and operative technique. The report should identify the femoral inflow, popliteal outflow, vein graft, and bypass performed. CMS assigns major surgery a 90-day global period, including the day-before preoperative visit and related postoperative care through day 90. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be allowed; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
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.
Where 35556 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $1,248.26 |
| Beaumont | Unavailable | $1,230.92 |
| Brazoria | Unavailable | $1,218.68 |
| Dallas | Unavailable | $1,237.65 |
| Fort Worth | Unavailable | $1,238.83 |
| Galveston | Unavailable | $1,229.64 |
| Houston | Unavailable | $1,350.81 |
| Rest Of Texas | Unavailable | $1,231.78 |
How the 35556 rate is calculated
Each of 35556’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 · 35556
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 26.08Practice expense 5.08Malpractice 6.62
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 35556
35556 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 35556
Arterial bypass
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| 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. |
| Split (54/55/56) | 0.09/0.84/0.07 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 35556
Arterial bypass
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
35556 without 50 · national facility
$1,261.89
Arterial bypass
35556-50 · Bilateral: 150%
$1,892.84
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
35556 compared with similar codes
Compare codes
35556 vs 35656 vs 35583 vs 35566: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 35656Arterial bypass
- Both codes describe a femoral-to-popliteal bypass, but 35556 is for a vein conduit; 35656 is for a conduit other than vein.
- 35583Vein bypass
- Both use a vein for a femoral-to-popliteal bypass. Choose 35583 when the vein is used in situ rather than as a vein graft.
- 35566Leg bypass
- This code also describes a vein bypass, but its distal target is an anterior tibial, posterior tibial, or peroneal artery rather than the popliteal artery.
35556 billing questions
How does this differ from an in-situ vein bypass?
This code describes a femoral-to-popliteal bypass using a vein graft. Use the in-situ bypass code when the vein remains in place and is used as the bypass conduit.
When would a non-vein bypass code be considered?
Use the corresponding non-vein graft code when the operative report documents a conduit other than vein for the femoral-to-popliteal bypass.
What documentation supports reporting this code?
Document the femoral inflow site, popliteal outflow site, vein conduit, and bypass technique. The operative report should make the route and graft material clear.
How is this handled when both legs are treated?
For a bilateral procedure, report modifier 50; CMS pays the bilateral procedure at 150%.
What payment rules apply when other procedures are performed in the same session?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%. The 90-day global period includes related postoperative care through day 90 and the day-before preoperative visit.
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
Fee sheets
Put 35556 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →