No office rate
Choose 35647 for a vein bypass from the aorta to one femoral artery. Code 35646 is for an aortobifemoral bypass with bilateral femoral outflow.
On this page
CMS RVU26D · Effective 2026-10-01
35647 Aortic bypass Medicare reimbursement rates in Virginia
Open bypass from the aorta to one femoral artery using a vein conduit, typically to restore blood flow for aortoiliac occlusive disease. Compare 35647 office and facility rates across CMS payment localities in Virginia.
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 35647 in Virginia?
Virginia 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
$1283.79–$1464.82
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 35647: Aorta-to-femoral vein bypass
Open bypass from the aorta to one femoral artery using a vein conduit, typically to restore blood flow for aortoiliac occlusive disease.
This service covers an open surgical bypass that carries blood from the aorta to a femoral artery through a vein graft. Vascular surgeons typically perform it in a hospital operating room for severe aortoiliac occlusive disease when improved blood flow to a leg is needed. The single femoral outflow distinguishes it from a bypass supplying both femoral arteries.
Report the code when the operative record supports the aorta-to-femoral route and use of a vein conduit. Document the indication, graft material, inflow and outflow vessels, and laterality. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures at 50%. If reported bilaterally with modifier 50, payment is at 150%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 35647
- 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 RVU28.99 · 71%
- Practice expense (office) RVU4.28 · 11%
- Malpractice RVU7.42 · 18%
73
Medicare services in 2024 · #5119 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.
35647 compared with similar codes
Office rates for Virginia, from the same CMS release.
No office rate
Code 35637 ends at an iliac artery; this code ends at a femoral artery and uses a vein conduit.
No office rate
Code 35638 supplies both iliac arteries. This code supplies one femoral artery through a vein bypass.
Compare 35647 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
Dc + Md/Va Suburbs →
Office / nonfacility
Unavailable
Facility
$1464.82
Virginia →
Office / nonfacility
Unavailable
Facility
$1283.79
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35647 billing questions
How is this different from 35646?
This code is for an aorta-to-one-femoral-artery bypass using a vein conduit. Code 35646 describes an aortobifemoral bypass, with both femoral arteries as outflow targets.
What documentation supports this code?
The operative report should identify the aortic inflow, femoral outflow, vein conduit, laterality, and reason for bypass. These details distinguish it from bypasses to iliac or other arterial targets.
Is related postoperative care separately reported?
Related postoperative care during the 90-day global period is included, along with the day-before preoperative visit.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How does Medicare handle another procedure performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%. When this code is reported bilaterally with modifier 50, payment is 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.
4,38635642,,Bpg carotid-vertebral,A,,18.47,3.90,NA,3.90,,4.72,27.09,27.09,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,38735645,,Bpg subclavian-vertebral,A,,17.97,3.31,NA,3.31,,4.60,25.88,25.88,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,38835646,,Bpg aortobifemoral,A,,32.16,5.87,NA,5.87,,8.17,46.20,46.20,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,38935647,,Bpg aortofemoral,A,,28.99,4.28,NA,4.28,,7.42,40.69,40.69,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,39035650,,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