Billing code 35587: Vein bypassMedicare rate & RVUs in Texas
Reports a vein-graft bypass from the popliteal artery to a tibial or peroneal artery, commonly performed to restore blood flow to an ischemic leg.
CMS doesn’t publish an office rate for 35587 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 35587 covers
This code describes a surgical bypass using a vein graft to route blood from the popliteal artery to a tibial or peroneal artery. Vascular surgeons typically perform it in an operating room for severe lower-extremity arterial disease when restoring blood flow to the foot or leg is needed, often as a limb-salvage procedure. The operative report should identify the inflow artery, the distal target, and use of a vein graft.
Choose this code when the bypass begins at the popliteal artery and ends at a tibial or peroneal artery; a femoral origin points to a different bypass code. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral procedures reported with modifier 50, CMS pays at 150%. Assistant-at-surgery payment may be available; 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 35587 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 | $1,197.47 |
| Beaumont | Unavailable | $1,184.28 |
| Brazoria | Unavailable | $1,170.03 |
| Dallas | Unavailable | $1,188.60 |
| Fort Worth | Unavailable | $1,190.02 |
| Galveston | Unavailable | $1,180.78 |
| Houston | Unavailable | $1,300.30 |
| Rest Of Texas | Unavailable | $1,184.11 |
How the 35587 rate is calculated
Each of 35587’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 · 35587
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 25.55Practice expense 4.22Malpractice 6.53
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 35587
35587 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 35587
Vein 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 · 35587
Vein 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
35587 without 50 · national facility
$1,212.45
Vein bypass
35587-50 · Bilateral: 150%
$1,818.68
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).
35587 compared with similar codes
Compare codes
35587 vs 35585 vs 35571 vs 35583: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 35585Vein bypass
- Both describe a vein bypass to a tibial or peroneal artery. Use 35587 for popliteal inflow and 35585 for femoral inflow.
- 35571Arterial bypass
- The inflow and outflow anatomy is similar, but 35571 describes a bypass using a graft other than vein; 35587 is for a vein graft.
- 35583Vein bypass
- Both are vein-graft bypasses, but 35583 runs from the femoral to the popliteal artery rather than from the popliteal artery to a tibial or peroneal artery.
35587 billing questions
How is 35587 distinguished from 35585?
Check the bypass inflow artery. 35587 is for a popliteal origin; 35585 is for a femoral origin, with a tibial or peroneal outflow.
Does the bypass need to use a vein graft?
Yes. The operative documentation should support use of a vein graft as well as the popliteal inflow and tibial or peroneal target.
What documentation supports reporting this code?
Document the indication, the inflow and outflow arteries, and the conduit used. The operative report should make clear that the bypass runs from the popliteal artery to a tibial or peroneal artery.
How is bilateral surgery handled?
CMS pays bilateral procedures reported with modifier 50 at 150%. The record should support a bypass on each side.
Are assistant and co-surgeon services payable?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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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