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CPT code 35180: AV fistula repair, congenital, head and neck2026 Medicare rate & RVUs

Surgical repair of a congenital artery-to-vein fistula in the head or neck, reported when the surgeon treats the abnormal connection operatively.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $717.12 for 35180 nationally in a facility.

Medicare rate · 35180

AV fistula repair, congenital, head and neck

Office or facility?

Work RVUs
14.72
Total RVUs
21.47
Global days
090

National rate · 2026

$717.12

Facility setting, before claim adjustments.

See every locality for 35180 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 35180 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 35180 covers

35180 describes operative repair of a congenital arteriovenous fistula located in the head or neck. The surgeon treats an abnormal artery-to-vein connection that has been present since birth; the operation may involve interrupting the connection and addressing the involved vessels. Vascular surgeons and other surgeons managing head and neck vascular lesions may perform the procedure in a hospital operating room.

Report this code when the documented lesion is congenital, is in the head or neck, and is surgically repaired. The operative report should support the lesion’s origin, location, and repair performed. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in one session, the highest-valued is paid in full and the others at 50%. Modifier 50 is inappropriate. An assistant at surgery may be paid; 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 35180 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

35180 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$650.23
AlaskaUnavailable$913.22
ArizonaUnavailable$695.97
ArkansasUnavailable$642.24
Atlanta, GAUnavailable$745.37
Austin, TXUnavailable$709.63
Bakersfield, CAUnavailable$687.10
Baltimore area, MDUnavailable$761.98
Beaumont, TXUnavailable$699.21
Brazoria, TXUnavailable$692.59

35180 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
35180 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 35180 rate is calculated

Each of 35180’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 · 35180

RVUs × geographic indexes × conversion factor

Office or facility?

Work14.72

14.72 RVUs× 1.000 GPCI

Practice expense3.00

3.00 RVUs× 1.000 GPCI

Malpractice3.75

3.75 RVUs× 1.000 GPCI

Adjusted RVUs

21.4700

Conversion factor

$33.4009

Medicare rate

$717.12

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 35180

35180 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 35180

AV fistula repair, congenital, head and neck

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.84/0.07Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 35180

AV fistula repair, congenital, head and neck

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

35180 without 51 · national facility

$717.12

AV fistula repair, congenital, head and neck

35180-51 · Second procedure: 50%

$358.56

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

35180 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 35180

    AV fistula repair, congenital, head and neck14.72 wRVU

    Not priced

  • 35188

    AV fistula repair, acquired, head and neck17.55 wRVU

    Not priced

  • 35182

    AV fistula repair, congenital, thorax or abdomen30.92 wRVU

    Not priced

  • 35184

    Fistula repair, congenital, extremity18.35 wRVU

    Not priced

How to choose

35188AV fistula repairAcquired, head and neck
Both address a head or neck fistula, but 35180 is for congenital origin and 35188 is for acquired origin.
35182AV fistula repairCongenital, thorax or abdomen
Both are for congenital fistula repair; 35182 applies to the thorax or abdomen rather than the head or neck.
35184Fistula repairCongenital, extremity
Both are for congenital fistula repair; 35184 applies to an extremity rather than the head or neck.

Codes related to 35180

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 35180
CodeHow it relatesNational office range
Same family
35182AV fistula repair, congenital, thorax or abdomenCongenital fistula repair code for the thorax or abdomen.No office rate
35184Fistula repair, congenital, extremityCongenital fistula repair code for an extremity.No office rate
Used instead
35188AV fistula repair, acquired, head and neckHead and neck fistula repair when the fistula is acquired rather than congenital.No office rate

35180 billing questions

How do I distinguish 35180 from 35188?

Use 35180 for a congenital fistula in the head or neck. Code 35188 describes repair of an acquired fistula at that location.

Which code applies when the congenital fistula is outside the head and neck?

Choose the congenital fistula code for the documented site: 35182 for the thorax or abdomen, or 35184 for an extremity.

Is modifier 50 appropriate for bilateral repair?

No. CMS identifies bilateral adjustment as inappropriate for this code.

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.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.

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
RVUs for 35180PPRRVU2026_Oct_nonQPP.csv, line 4,286 (RVU26D)

Open CMS sourceHow we calculate rates

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