No office rate
Choose 35685 for patch angioplasty performed to support graft patency; 35686 describes a distal arteriovenous fistula used for that purpose.
On this page
CMS RVU26D · Effective 2026-10-01
35685 Bypass patch Medicare reimbursement rates in Texas
An add-on for a bypass operation when a patch angioplasty is performed to support graft patency, such as with a profunda outflow repair. Compare 35685 office and facility rates across CMS payment localities in Texas.
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 35685 in Texas?
Texas has 8 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 8 payment areas shown below, using the same CMS release.
Office / nonfacility
No 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.
Where 35685 pays more and less in Texas
Vascular surgery
About 35685: Bypass patency patch angioplasty
An add-on for a bypass operation when a patch angioplasty is performed to support graft patency, such as with a profunda outflow repair.
This add-on represents patch angioplasty performed as an adjunct to an arterial bypass to improve or maintain graft outflow and patency. A vascular surgeon may use it when the artery at the bypass outflow requires enlargement; profundaplasty is a typical example. The patch is part of the open operation, not a separate later procedure. It is generally encountered in facility-based vascular surgery, including lower-extremity revascularization for significant arterial disease.
Report 35685 only with the primary bypass procedure when the operative note supports a distinct patch angioplasty for graft patency. Documentation should identify the bypass, the artery treated, and the patch work performed; a routine anastomosis alone does not establish this service. This is an add-on code, not a standalone bypass code. Medicare pays it within the primary procedure's global period, so it is reported with that primary procedure rather than as an independent service.
CMS billing rules for 35685
- 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 RVU3.94 · 74%
- Practice expense (office) RVU0.39 · 7%
- Malpractice RVU1.02 · 19%
363
Medicare services in 2024 · #3818 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.
35685 compared with similar codes
Office rates for Texas, from the same CMS release.
No office rate
35656 describes the femoral-popliteal bypass itself. 35685 is an add-on for a separate patch angioplasty performed to support patency during the bypass operation.
No office rate
35666 describes a femoral bypass to a distal leg artery; it is the primary bypass procedure, while 35685 reports an accompanying patency patch when performed.
Compare 35685 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.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Office Unavailable | Facility $175.83 |
| Beaumont | Office Unavailable | Facility $175.10 |
| Brazoria | Office Unavailable | Facility $172.14 |
| Dallas | Office Unavailable | Facility $174.99 |
| Fort Worth | Office Unavailable | Facility $175.30 |
| Galveston | Office Unavailable | Facility $173.80 |
| Houston | Office Unavailable | Facility $192.47 |
| Rest Of Texas | Office Unavailable | Facility $174.73 |
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35685 billing questions
When should 35685 be reported with a bypass?
Report it when the surgeon performs a patch angioplasty as an adjunct to the bypass to support graft patency. The operative note should describe the artery patched and the additional patch work.
Can 35685 be billed by itself?
No. It is an add-on code and must be reported with a primary bypass procedure.
How is 35685 different from 35686?
35685 represents a patch angioplasty for graft patency. 35686 represents a distal arteriovenous fistula used to support bypass patency, a different adjunct technique.
Is a patch included in the primary bypass code?
A routine bypass anastomosis does not support separate reporting of 35685. Report the add-on when documentation shows the distinct patch angioplasty performed for graft patency.
What documentation supports 35685?
The operative report should identify the bypass and the artery receiving the patch, and describe the patch angioplasty as an adjunct to maintain or improve graft patency.
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.
4,39835681,,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
4,40335691,,Art trnsposj vertbrl carotid,A,,17.95,3.31,NA,3.31,,4.58,25.84,25.84,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,40435693,,Art trnsposj subclavian,A,,15.34,3.73,NA,3.73,,3.91,22.98,22.98,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00