Billing code 35683: Composite bypass graftMedicare rate & RVUs in Washington
Report this add-on when an arterial bypass uses a composite graft constructed from three or more segments, alongside the primary bypass procedure.
CMS doesn’t publish an office rate for 35683 in Washington.
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 35683 covers
This add-on describes the graft construction used during an arterial bypass when the composite graft comprises three or more segments. A vascular surgeon typically performs the bypass in an operating room, using the graft to route blood around an obstructed or diseased artery. The primary bypass code identifies the bypass procedure and its anatomic route; this code identifies the qualifying composite graft configuration.
Report it only with a primary bypass procedure, not as a stand-alone service. The operative report should support the bypass performed and document the graft construction, including the number of segments used. For example, a femoral-to-popliteal or femoral-to-tibial bypass may have a composite graft configuration; select the primary code for the documented route and use this add-on when the graft has three or more segments. CMS pays it within the primary procedure's global period.
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 35683 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $357.00 |
| Seattle (King Cnty) | Unavailable | $375.01 |
How the 35683 rate is calculated
Each of 35683’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 · 35683
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 8.28Practice expense 0.66Malpractice 2.11
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 35683
The CMS indicators that decide how 35683 is paid alongside other services.
CMS payment indicators · 35683
Composite bypass graft
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
35683 compared with similar codes
Compare codes
35683 vs 35681 vs 35682 vs 35656 vs 35666: national Medicare rates
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How to choose
- 35681Composite bypass graft
- This composite graft code specifies prosthetic material combined with vein; 35683 identifies a graft made from three or more segments.
- 35682Composite bypass
- This code describes a composite graft using two veins. Use 35683 for the three-or-more-segment category.
- 35656Arterial bypass
- 35656 identifies a femoral-popliteal bypass using a non-vein graft; 35683 is an add-on for qualifying composite graft construction, not a bypass-route code.
- 35666Leg bypass
- 35666 identifies a femoral-to-tibial or peroneal bypass using a non-vein graft; 35683 describes the qualifying composite graft configuration.
35683 billing questions
Can 35683 be billed by itself?
No. It is an add-on code and must be reported with a primary bypass procedure.
How is 35683 different from 35682?
35683 is the composite graft category for three or more segments; 35682 describes a composite graft using two veins.
What should the operative report document?
Document the bypass route and the graft construction, including the number of segments supporting selection of the three-or-more-segment category.
Is this code reported once for each graft segment?
It identifies the three-or-more-segment composite graft category; it is not a per-segment code.
Which code identifies the bypass route?
The primary bypass code identifies the route, such as femoral-to-popliteal or femoral-to-tibial. Report 35683 as the add-on when the graft configuration meets its segment criterion.
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
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