CPT code 35188: AV fistula repair, acquired, head and neck2026 Medicare rate & RVUs in Colorado

Reports operative repair of an acquired abnormal artery-to-vein connection in the head or neck, rather than a congenital fistula or one at another site.

CMS RVU26DEffective Oct 1, 2026One payment locality

In Colorado, Medicare pays $1,243.54 for 35188 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$1,243.54Hospital or facility

Check a contract rate as a % of Medicare · 35188 nationwide

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

We’ll open 35188 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Colorado
  2. What 35188 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 35188 covers

A vascular surgeon typically reports this service for operative treatment of an acquired arteriovenous fistula in the head or neck, such as one resulting from trauma or a prior procedure. The surgeon exposes the abnormal connection and repairs it to interrupt the direct flow between artery and vein. The service is generally performed in a hospital operating room.

Select the code when the operative record supports an acquired fistula and identifies its head-and-neck location; congenital fistulas and fistulas in the thorax, abdomen, or extremities have different codes. The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard reduction. Modifier 50 is not appropriate for this repair. Assistant-at-surgery payment may be available; 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.

How Colorado compares for 35188

Across 109 of 109 payment localities, the facility rate for 35188 runs from $1,073.91 in Wisconsin to $1,659.26 in Miami, FL. Colorado pays $1,243.54. The RVUs are the same everywhere; the geographic indexes change the dollars.

35188 in Colorado vs other payment areas
  1. Colorado · this page$1,243.54
  2. Los Angeles, CA · California$1,282.70+$39.16
  3. Washington, DC area · District of Columbia$1,399.30+$155.76
  4. Miami, FL · Florida$1,659.26+$415.72
  5. Chicago, IL · Illinois$1,589.99+$346.45
  6. Manhattan, NY · New York$1,515.36+$271.82
  7. Alaska · Alaska$1,473.11+$229.57

Other areas in Colorado first, then benchmark localities. Bars start at $0.

Every other payment area

35188 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$1,102.11
ArkansasArkansas—$1,082.62
ArizonaArizona—$1,214.27
Bakersfield, CACalifornia—$1,218.82
Chico, CACalifornia—$1,199.58
El Centro, CACalifornia—$1,200.82
Fresno, CACalifornia—$1,199.58
Hanford, CACalifornia—$1,199.58

35188 rates by state

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

Explore a state

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
35188 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

See 35188 in every payment locality

How the 35188 rate is calculated

Each of 35188’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 · 35188

RVUs × geographic indexes × conversion factor

Office or facility?

Work17.55

17.55 RVUs× 1.000 GPCI

Practice expense12.86

12.86 RVUs× 1.000 GPCI

Malpractice7.41

7.41 RVUs× 1.000 GPCI

Adjusted RVUs

37.8200

Conversion factor

$33.4009

Medicare rate

$1,263.22

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

The exact Colorado inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,289

Code
35188
Physician work
17.55
Practice expense
12.86
Malpractice
7.41

GPCI2026.csv

37

Locality
Colorado
Physician work
1.012
Practice expense
1.064
Malpractice
0.781
Facility calculation for 35188 in Colorado
ComponentRVULocality factorAdjusted
Physician work17.55× 1.01217.7606
Practice expense12.86× 1.06413.6830
Malpractice7.41× 0.7815.7872
Total RVUs37.2309
Conversion factor× 33.4009

Facility rate, Colorado$1243.54

Facility: (17.55 × 1.012 + 12.86 × 1.064 + 7.41 × 0.781) × $33.4009 = $1243.54

Open 35188 in the RVU calculator

Payment rules and modifiers for 35188

35188 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 35188

AV fistula repair, acquired, 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 · 35188

AV fistula repair, acquired, 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

35188 without 51 · national facility

$1,263.22

AV fistula repair, acquired, head and neck

35188-51 · Second procedure: 50%

$631.61

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

How 35188 has changed in Colorado

35188 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$1,243.54RVU26D
2026-07-01Not available in this setting$1,243.54RVU26C
2026-04-01Not available in this setting$1,243.54RVU26B
2026-01-01Not available in this setting$1,243.54RVU26A
2025-10-01Not available in this setting$1,258.10RVU25D
2025-07-01Not available in this setting$1,258.10RVU25C
2025-04-01Not available in this setting$1,258.10RVU25B
2025-01-01Not available in this setting$1,258.10RVU25A
2024-10-01Not available in this setting$1,287.84RVU24D
2024-07-01Not available in this setting$1,287.84RVU24C
2024-04-01Not available in this setting$1,287.84RVU24B
2024-03-09Not available in this setting$1,287.84RVU24AR
2024-01-01Not available in this setting$1,266.82RVU24A
2023-10-01Not available in this setting$1,288.57RVU23D
2023-07-01Not available in this setting$1,288.57RVU23C
2023-04-01Not available in this setting$1,288.57RVU23B
2023-01-01Not available in this setting$1,288.57RVU23A
2022-10-01Not available in this setting$1,285.05RVU22D
2022-07-01Not available in this setting$1,285.05RVU22C
2022-04-01Not available in this setting$1,285.05RVU22B
2022-01-01Not available in this setting$1,285.05RVU22A
2021-10-01Not available in this setting$1,286.79RVU21D
2021-07-01Not available in this setting$1,286.79RVU21C
2021-04-01Not available in this setting$1,286.79RVU21B
2021-01-01Not available in this setting$1,286.79RVU21A
2020-10-01Not available in this setting$1,326.52RVU20D
2020-07-01Not available in this setting$1,326.52RVU20C
2020-04-01Not available in this setting$1,326.52RVU20B
2020-01-01Not available in this setting$1,326.52RVU20A
2019-10-01Not available in this setting$1,378.27RVU19D
2019-07-01Not available in this setting$1,378.27RVU19C
2019-04-01Not available in this setting$1,354.61RVU19B
2019-01-01Not available in this setting$1,354.61RVU19A
2018-10-01Not available in this setting$1,375.97RVU18D
2018-07-01Not available in this setting$1,375.97RVU18C
2018-04-01Not available in this setting$1,375.97RVU18B
2018-01-01Not available in this setting$1,375.97RVU18AR1
2017-10-01Not available in this setting$1,131.51RVU17D
2017-07-01Not available in this setting$1,131.51RVU17C
2017-04-01Not available in this setting$1,131.51RVU17B
2017-01-01Not available in this setting$1,131.51RVU17A
2016-10-01Not available in this setting$1,225.60RVU16D
2016-07-01Not available in this setting$1,225.60RVU16C
2016-04-01Not available in this setting$1,225.60RVU16B
2016-01-01Not available in this setting$1,225.60RVU16A
2015-10-01Not available in this setting$1,141.51RVU15D
2015-07-01Not available in this setting$1,141.51RVU15C
2015-04-01Not available in this setting$1,135.83RVU15B
2015-01-01Not available in this setting$1,135.83RVU15A
2014-10-01Not available in this setting$1,247.53RVU14D
2014-07-01Not available in this setting$1,247.53RVU14C
2014-04-01Not available in this setting$1,247.53RVU14B
2014-01-01Not available in this setting$1,247.53RVU14A
2013-10-01Not available in this setting$931.59RVU13D
2013-07-01Not available in this setting$931.59RVU13C
2013-04-01Not available in this setting$931.59RVU13B
2013-01-01Not available in this setting$931.59RVU13AR

Price 35188 for an earlier date of service

Where the Colorado rate applies

Colorado is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in Colorado. Some span more than one payment area; confirm with the service ZIP.

  • Acres Green
  • Aetna Estates
  • Aguilar
  • Air Force Academy
  • Akron
  • Alamosa
  • Alamosa East
  • Allenspark

Browse all communities in Colorado

35188 billing questions

How is this code distinguished from 35180?

35188 is for an acquired head-and-neck fistula. 35180 is the corresponding code for a congenital fistula in that region.

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

Use the acquired-fistula code matching the documented location: 35189 for the thorax or abdomen, or 35190 for an extremity.

What documentation supports reporting 35188?

The operative report should establish that the fistula is acquired, identify its head-and-neck location, and describe the repair performed.

Are related postoperative visits included?

Yes. The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.

Can modifier 50 be used, and what about assistant or co-surgeon billing?

Modifier 50 is not appropriate for this repair. Assistant-at-surgery payment may be available, while co-surgeon payment requires supporting documentation.

How are other procedures performed in the same session paid?

The highest-valued procedure is paid in full; other procedures in the same session are subject to the standard multiple-procedure reduction.

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 35188PPRRVU2026_Oct_nonQPP.csv, line 4,289 (RVU26D)
Geographic factors for ColoradoGPCI2026.csv, line 37 (RVU26D)

Open CMS sourceHow we calculate rates

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