CPT code 35221: Vessel repair, direct repair, intra-abdominal2026 Medicare rate & RVUs

Medicare pays $1,338.37 for 35221 nationally in a facility.

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

What 35221 covers

This code describes direct repair of a blood vessel within the abdomen, typically by closing a defect in the vessel without inserting a graft. It may be performed by a vascular, trauma, or general surgeon when an abdominal vessel is injured, including during trauma care or another operation. The operative report should identify the vessel and its location and describe the direct repair performed.

Report this code when the documented work is a direct intra-abdominal vessel repair; a repair using a vein graft or another type of graft belongs to a different code. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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% reduction. For bilateral reporting with modifier 50, CMS pays at 150%. Assistant-at-surgery services may be paid; co-surgeons are paid only with 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 35221 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

35221 rates by state

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

How the 35221 rate is calculated

Each of 35221’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.

Payment rules and modifiers for 35221

35221 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

35221 compared with similar codes

How to choose

35251Vessel repairIntra-abdominal vein graft

Both concern intra-abdominal vessels, but 35251 is for repair using a vein graft. Choose 35221 for direct repair without an interposed graft.

35281Vessel repairNonvenous graft, intra-abdominal

35281 covers intra-abdominal vessel repair using a graft other than a vein graft. This code is for direct repair.

35211Vessel repairIntrathoracic, with bypass

35211 concerns direct repair of an intrathoracic vessel with bypass. This code is for an intra-abdominal vessel.

35216Vessel repairIntrathoracic, direct, no bypass

35216 concerns direct repair of an intrathoracic vessel without bypass. Select this code when the repaired vessel is intra-abdominal.

Codes related to 35221

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

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

Open CMS sourceHow we calculate rates