Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerBilling CodesVein Bypass Graft ProceduresCPT cpt-35556-femoral-to-popliteal-vein-bypass-graft
    Ask Trek AI about this page

    CPT 35556: Femoral to Popliteal Artery Bypass with Vein Graft

    Medicare pays $1261 on average nationally for this procedure.

    CPT code 35556 describes a surgical femoral-to-popliteal bypass using a vein graft to bypass an occluded arterial segment; the service is a vascular surgery procedure typically performed in an operating room or inpatient surgical setting to restore lower-extremity blood flow and limb perfusion.

    For related coverage guidance, see recent payer policy updates: Cardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA), Cardiovascular Disease Risk Assessment, Biomarkers for Myocardial Infarction and Chronic Heart Failure.

    Customize your policy alerts

    Sign up for cpt 35556 policy alerts

    Get alerted when payer policies referencing 35556 are released or updated.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Table of contents

    Progress1 / 7

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Clinical & Coding Specifications

    Clinical Context

    A 68-year-old male with long-standing peripheral arterial disease presents with progressive right lower-extremity rest pain and non-healing ulceration of the lateral ankle. Noninvasive arterial Doppler studies and lower-extremity angiography demonstrate an occlusive lesion of the superficial femoral artery with inadequate runoff to the distal popliteal segment. The vascular surgery team schedules an open femoral–popliteal bypass using an autogenous vein graft.

    The clinical workflow includes preoperative vascular assessment (ankle-brachial index, duplex ultrasound, CTA or diagnostic angiography), medical optimization (antiplatelet therapy, statin, smoking cessation counseling), informed consent discussing risks (bleeding, infection, graft occlusion), operative procedure (harvest of ipsilateral or contralateral greater saphenous vein, proximal femoral arteriotomy, tunneling of vein graft, distal popliteal anastomosis), immediate postoperative monitoring in PACU or step-down unit, duplex graft surveillance before discharge, and scheduled follow-up for wound care and surveillance imaging. Typical site of service is an operating room in a hospital or an ambulatory surgical center for lower-extremity bypass when inpatient admission is not required.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    35556Femoral to popliteal bypass with vein graft (as described)Primary operative code for the open bypass connecting femoral to popliteal artery with autogenous vein graft.
    36147Introduction of peripheral catheter for diagnostic angiography, lower extremity, percutaneousDiagnostic angiography codes may be used preoperatively for angiographic mapping if performed separately.
    37224Revascularization, endovascular, open or percutaneous, femoropopliteal artery, with stent(s)Endovascular alternative or adjunct performed before or after bypass in hybrid procedures.
    35341Anastomosis, direct, arterial, open; femoral to popliteal (single segment)Related open arterial anastomosis codes that describe operative segments; used when coding variations or component reporting are required.
    93925Duplex scan of arterial inflow and outflow of lower extremity with spectral and color flowPre- and postoperative noninvasive surveillance commonly performed to assess graft patency.
    99223Initial hospital care, typically 70 minutes or more, high complexity (example inpatient preop/postop)Inpatient evaluation and management services for a patient admitted for the bypass procedure.

    Related Modifiers

    11 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    51Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…

    Showing 1–10 of 11

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207P00000XEmergency Medicine PhysicianAn emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospit…
    208000000XPediatrics PhysicianA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
    2080P0207XPediatric Hematology & Oncology PhysicianA pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous disea…
    163WM0705XMedical-Surgical Registered NurseNursing Service Providers · Registered Nurse
    174MM1900XMedical Research VeterinarianOther Service Providers · Veterinarian
    207RG0300XGeriatric Medicine (Internal Medicine) PhysicianAn internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects o…
    374700000XTechnician(1) A person with specialized training in a narrow field of expertise whose occupation requires training and is skilled in specific technical processe…
    282J00000XReligious Nonmedical Health Care InstitutionFurnishes only nonmedical nursing items and services to patients who choose to rely solely upon a religious method of healing, and for whom the accept…

    Related ICD-10-CM Codes

    16 rows

    ICD-10-CM CodeDescription
    E11.52Type 2 diabetes mellitus with diabetic peripheral angiopathy with gangrene
    E78.5Hyperlipidemia, unspecified
    I10Essential (primary) hypertension
    I70.213Atherosclerosis of native arteries of extremities with intermittent claudication, bilateral legs
    I70.223Atherosclerosis of native arteries of extremities with rest pain, bilateral legs
    I70.243Atherosclerosis of native arteries of left leg with ulceration of ankle
    I70.244Atherosclerosis of native arteries of left leg with ulceration of heel and midfoot
    I70.261Atherosclerosis of native arteries of extremities with gangrene, right leg
    I70.262Atherosclerosis of native arteries of extremities with gangrene, left leg
    I70.291Other atherosclerosis of native arteries of extremities, right leg

    Showing 1–10 of 16

    Related Payer Policy Updates

    Specialty: Cardiology1 / 2

    6 rows

    PolicyPayerEffective Date
    Cardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA)univerahealthcare2026-10-15
    Cardiovascular Disease Risk AssessmentOscar Health2026-10-01
    Biomarkers for Myocardial Infarction and Chronic Heart FailureOscar Health2026-10-01
    Multiple Procedure Payment Reduction for Diagnostic Cardiovascular ProceduresBlue Cross Blue Shield - Maine2026-10-01
    Cardiovascular Disease Risk Assessmentblue cross blue shield - louisiana2026-09-15
    Cardiovascular Disease Risk AssessmentBlue Cross Blue Shield - New Mexico2026-09-04

    Related Codes

    CPT-35500-ARM-VEIN-HARVEST-FOR-BYPASS-CONDUIT

    CPT 35500: Upper Extremity Vein Harvest for Bypass Conduit

    CPT-35501-CAROTID-COMMON-TO-INTERNAL-ARTERY-BYPASS-GRAFT

    CPT 35501: Carotid Bypass, Common to Internal Carotid Artery

    CPT-35506-CAROTID-TO-SUBCLAVIAN-BYPASS-GRAFT

    CPT 35506: Carotid to Subclavian Bypass Graft

    CPT-35508-CAROTID-TO-VERTEBRAL-BYPASS-GRAFT

    CPT 35508: Carotid-to-Vertebral Artery Bypass Graft

    CPT-35509-CAROTID-TO-CAROTID-VEIN-BYPASS-GRAFT

    CPT 35509: Carotid-to-Carotid Vein Bypass Graft

    CPT-35510-CAROTID-TO-BRACHIAL-ARTERY-BYPASS-VEIN-GRAFT

    CPT 35510: Carotid-to-Brachial Vein Bypass Graft

    CPT-35511-SUBCLAVIAN-ARTERY-TO-SUBCLAVIAN-ARTERY-VEIN-BYPASS

    CPT 35511: Subclavian-to-Subclavian Vein Bypass Graft

    CPT-35512-SUBCLAVIAN-TO-BRACHIAL-ARTERY-VEIN-BYPASS

    CPT 35512: Subclavian-to-Brachial Artery Bypass with Vein Graft

    CPT-35515-SUBCLAVIAN-TO-VERTEBRAL-ARTERY-BYPASS-VEIN-GRAFT

    CPT 35515: Subclavian to Vertebral Artery Bypass with Vein Graft

    CPT-35516-SUBCLAVIAN-TO-AXILLARY-VEIN-BYPASS

    CPT 35516: Subclavian to Axillary Vein Bypass Graft

    Showing 1–10 of 32

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
    Published by

    Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.