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CPT code 35246: Vessel repair, intrathoracic, without bypass2026 Medicare rate & RVUs

Reports reconstruction of an intrathoracic blood vessel with a vein graft when the repair restores the vessel without creating a bypass route.

CMS RVU26DEffective Oct 1, 2026109 payment localities32 Medicare services in 2024

Medicare pays $1,484.00 for 35246 nationally in a facility.

Medicare rate · 35246

Vessel repair, intrathoracic, without bypass

Office or facility?

Work RVUs
27.52
Total RVUs
44.43
Global days
090

National rate · 2026

$1,484.00

Facility setting, before claim adjustments.

See every locality for 35246 →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 35246 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 35246 covers

A surgeon uses a vein graft to repair a damaged or diseased blood vessel inside the chest, restoring continuity at the site rather than routing blood around it. This may be needed during open thoracic surgery for an injury or when removing a diseased vessel segment leaves a defect that requires graft reconstruction. Vascular, thoracic, or cardiothoracic surgeons typically perform the operation in a hospital operating room.

Select this code when the operative report supports both the intrathoracic location and use of a vein graft, and shows that the reconstruction is not a bypass. Document the vessel repaired, the graft material, and the repair performed. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care. For procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Modifier 50 bilateral reporting is paid at 150%. Assistant-at-surgery payment may be available; co-surgeons require 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 35246 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

35246 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,345.39
AlaskaUnavailable$1,867.17
ArizonaUnavailable$1,441.62
ArkansasUnavailable$1,328.65
Atlanta, GAUnavailable$1,536.52
Austin, TXUnavailable$1,480.74
Bakersfield, CAUnavailable$1,448.49
Baltimore area, MDUnavailable$1,576.04
Beaumont, TXUnavailable$1,437.35
Brazoria, TXUnavailable$1,439.83

35246 rates by state

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

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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
35246 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 35246 rate is calculated

Each of 35246’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 · 35246

RVUs × geographic indexes × conversion factor

Office or facility?

Work27.52

27.52 RVUs× 1.000 GPCI

Practice expense10.32

10.32 RVUs× 1.000 GPCI

Malpractice6.59

6.59 RVUs× 1.000 GPCI

Adjusted RVUs

44.4300

Conversion factor

$33.4009

Medicare rate

$1,484.00

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

Payment rules and modifiers for 35246

35246 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 35246

Vessel repair, intrathoracic, without bypass

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)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
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 · 35246

Vessel repair, intrathoracic, without bypass

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 50 · payment effect

With and without the modifier

35246 without 50 · national facility

$1,484.00

Vessel repair, intrathoracic, without bypass

35246-50 · Bilateral: 150%

$2,226.00

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).

When to use modifier 50

35246 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 35246

    Vessel repair, intrathoracic, without bypass27.52 wRVU

    Not priced

  • 35241

    Vascular repair, intrathoracic, vein graft with bypass24.94 wRVU

    Not priced

  • 35216

    Vessel repair, intrathoracic, direct, no bypass35.69 wRVU

    Not priced

  • 35276

    Vessel repair, intrathoracic, without bypass25.18 wRVU

    Not priced

How to choose

35241Vascular repairIntrathoracic, vein graft with bypass
Both use a vein graft for an intrathoracic vessel. Choose 35241 when the repair includes bypass; 35246 describes repair without bypass.
35216Vessel repairIntrathoracic, direct, no bypass
This is intrathoracic direct vessel repair without bypass and without a vein graft. Use 35246 when a vein graft is used.
35276Vessel repairIntrathoracic, without bypass
This describes intrathoracic repair without bypass using a graft other than a vein. Choose 35246 when the graft is a vein.

Codes related to 35246

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

Codes related to 35246
CodeHow it relatesNational office range
Same family
35241Vascular repair, intrathoracic, vein graft with bypassIntrathoracic vein-graft repair counterpart when the reconstruction includes bypass.No office rate
35251Vessel repair, intra-abdominal vein graftVein-graft vessel repair without bypass at an intra-abdominal site.No office rate
Used instead
35216Vessel repair, intrathoracic, direct, no bypassIntrathoracic repair without bypass when direct repair is performed without a graft.No office rate
35271Vascular graft repair, intrathoracic, with bypassIntrathoracic repair with a graft other than a vein, with bypass.No office rate
35276Vessel repair, intrathoracic, without bypassIntrathoracic repair with a graft other than a vein, without bypass.No office rate

35246 billing questions

How does this differ from 35241?

Both describe intrathoracic vessel repair using a vein graft. Use 35246 when the reconstruction is without bypass; 35241 is the with-bypass counterpart.

When would direct vessel repair be more appropriate?

If the surgeon repairs the intrathoracic vessel directly without using a graft, consider 35216 when the repair is without bypass.

What operative documentation supports 35246?

The report should identify the intrathoracic vessel, the vein graft used, and how the graft reconstructs the vessel without creating a bypass route.

How is bilateral reporting handled?

When the procedure is performed bilaterally, modifier 50 applies; CMS pays the bilateral procedure at 150%.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be available. Co-surgeons are paid only with supporting documentation; team surgery is not permitted.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of 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

Show the CMS file lines behind this rate
RVUs for 35246PPRRVU2026_Oct_nonQPP.csv, line 4,303 (RVU26D)

Open CMS sourceHow we calculate rates

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