CPT code 35206: Vessel repair, upper extremity, direct repair2026 Medicare rate & RVUs in Texas
Reports direct operative repair of an injured blood vessel in the upper extremity when the vessel can be repaired without a graft.
CMS doesn’t publish an office rate for 35206 in Texas.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 35206 covers
A vascular, trauma, or other qualified surgeon reports this service for direct repair of an upper-extremity blood vessel, such as a primary repair of a lacerated artery or vein or a direct end-to-end repair. The code is selected for the upper extremity; repairs in the hand or fingers and repairs in other body regions have separate site-specific codes. The repair is performed in an operative setting, commonly after traumatic vessel injury or during surgery when an injured vessel requires reconstruction.
Documentation should identify the vessel and upper-extremity site, the injury or defect, and the direct repair performed without a graft. This major surgery has a 90-day global period, including the day-before preoperative visit and related postoperative care for 90 days. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 bilateral reporting is paid at 150%. Assistant-at-surgery payment may be allowed; 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 35206 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | $722.92 |
| Beaumont, TX | Unavailable | $701.50 |
| Brazoria, TX | Unavailable | $703.22 |
| Dallas, TX | Unavailable | $712.67 |
| Fort Worth, TX | Unavailable | $712.33 |
| Galveston, TX | Unavailable | $708.57 |
| Houston, TX | Unavailable | $765.86 |
| Rest of Texas | Unavailable | $705.37 |
How the 35206 rate is calculated
Each of 35206’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 · 35206
RVUs × geographic indexes × conversion factor
Work13.49
13.49 RVUs× 1.000 GPCI
Practice expense5.06
5.06 RVUs× 1.000 GPCI
Malpractice3.13
3.13 RVUs× 1.000 GPCI
Adjusted RVUs
21.6800
Conversion factor
$33.4009
Medicare rate
$724.13
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 35206
35206 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 35206
Vessel repair, upper extremity, direct repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.84/0.07 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 35206
Vessel repair, upper extremity, direct repair
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
35206 without 50 · national facility
$724.13
Vessel repair, upper extremity, direct repair
35206-50 · Bilateral: 150%
$1,086.20
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
35206 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 35207Vessel repairDirect repair, hand or finger
- Both describe direct vessel repair, but 35207 is for the hand or fingers; 35206 is for other upper-extremity sites.
- 35226Vessel repairDirect repair, lower extremity
- This is the direct-repair code for the lower extremity. Choose 35206 when the repaired vessel is in the upper extremity.
- 35236Vessel repairUpper extremity, vein graft
- 35236 describes upper-extremity repair using a vein graft. Use 35206 when the vessel is repaired directly without a graft.
- 35266Vessel repairUpper extremity, nonvein graft
- 35266 describes upper-extremity repair using a graft other than a vein; 35206 is for direct repair without a graft.
35206 billing questions
How does this differ from the hand and finger repair code?
Use 35206 for direct vessel repair in the upper extremity outside the hand and fingers. Code 35207 identifies direct repair at the hand or finger site.
When is a graft code more appropriate?
This code describes direct repair without a graft. When the reconstruction uses a vein graft or a graft other than a vein, consider the corresponding upper-extremity graft code instead.
What documentation supports reporting 35206?
The operative report should establish the upper-extremity vessel and site, the injury or defect, and how the surgeon repaired it directly without a graft.
How are bilateral repairs and multiple procedures handled?
CMS pays bilateral reporting with modifier 50 at 150%. For multiple procedures in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction.
What should the practice know about surgical assistance and the global period?
Assistant-at-surgery payment may be allowed, while co-surgeon payment requires supporting documentation; team surgery is not permitted. The 90-day global includes the day-before preoperative visit and related postoperative care.
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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