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

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, 2026One payment locality32 Medicare services in 2024

In Oklahoma, Medicare pays $1,398.03 for 35246 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$1,398.03Hospital or facility

Check a contract rate as a % of Medicare · 35246 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 35246 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Oklahoma
  2. What 35246 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 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.

How Oklahoma compares for 35246

Across 109 of 109 payment localities, the facility rate for 35246 runs from $1,317.21 in Wisconsin to $1,867.17 in Alaska. Oklahoma pays $1,398.03. The RVUs are the same everywhere; the geographic indexes change the dollars.

35246 in Oklahoma vs other payment areas
  1. Oklahoma · this page$1,398.03
  2. Los Angeles, CA · California$1,510.81+$112.78
  3. Washington, DC area · District of Columbia$1,619.87+$221.84
  4. Miami, FL · Florida$1,834.69+$436.66
  5. Chicago, IL · Illinois$1,777.20+$379.17
  6. Manhattan, NY · New York$1,727.66+$329.63
  7. Alaska · Alaska$1,867.17+$469.14

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

Every other payment area

35246 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$1,345.39
ArkansasArkansas—$1,328.65
ArizonaArizona—$1,441.62
Bakersfield, CACalifornia—$1,448.49
Chico, CACalifornia—$1,430.59
El Centro, CACalifornia—$1,431.69
Fresno, CACalifornia—$1,430.59
Hanford, CACalifornia—$1,430.59

35246 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
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

See 35246 in every payment locality

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.

The exact Oklahoma inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,303

Code
35246
Physician work
27.52
Practice expense
10.32
Malpractice
6.59

GPCI2026.csv

86

Locality
Oklahoma
Physician work
1.000
Practice expense
0.893
Malpractice
0.777
Facility calculation for 35246 in Oklahoma
ComponentRVULocality factorAdjusted
Physician work27.52× 1.00027.5200
Practice expense10.32× 0.8939.2158
Malpractice6.59× 0.7775.1204
Total RVUs41.8562
Conversion factor× 33.4009

Facility rate, Oklahoma$1398.03

Facility: (27.52 × 1 + 10.32 × 0.893 + 6.59 × 0.777) × $33.4009 = $1398.03

Open 35246 in the RVU calculator

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

How 35246 has changed in Oklahoma

35246 · 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$1,398.03RVU26D
2026-07-01Not available in this setting$1,398.03RVU26C
2026-04-01Not available in this setting$1,398.03RVU26B
2026-01-01Not available in this setting$1,398.03RVU26A
2025-10-01Not available in this setting$1,411.87RVU25D
2025-07-01Not available in this setting$1,411.87RVU25C
2025-04-01Not available in this setting$1,411.87RVU25B
2025-01-01Not available in this setting$1,411.87RVU25A
2024-10-01Not available in this setting$1,445.94RVU24D
2024-07-01Not available in this setting$1,445.94RVU24C
2024-04-01Not available in this setting$1,445.94RVU24B
2024-03-09Not available in this setting$1,445.94RVU24AR
2024-01-01Not available in this setting$1,422.34RVU24A
2023-10-01Not available in this setting$1,464.92RVU23D
2023-07-01Not available in this setting$1,464.92RVU23C
2023-04-01Not available in this setting$1,464.92RVU23B
2023-01-01Not available in this setting$1,464.92RVU23A
2022-10-01Not available in this setting$1,494.26RVU22D
2022-07-01Not available in this setting$1,494.26RVU22C
2022-04-01Not available in this setting$1,494.26RVU22B
2022-01-01Not available in this setting$1,494.26RVU22A
2021-10-01Not available in this setting$1,500.55RVU21D
2021-07-01Not available in this setting$1,500.55RVU21C
2021-04-01Not available in this setting$1,500.55RVU21B
2021-01-01Not available in this setting$1,500.55RVU21A
2020-10-01Not available in this setting$1,560.18RVU20D
2020-07-01Not available in this setting$1,560.18RVU20C
2020-04-01Not available in this setting$1,560.18RVU20B
2020-01-01Not available in this setting$1,560.18RVU20A
2019-10-01Not available in this setting$1,590.91RVU19D
2019-07-01Not available in this setting$1,590.91RVU19C
2019-04-01Not available in this setting$1,578.54RVU19B
2019-01-01Not available in this setting$1,578.54RVU19A
2018-10-01Not available in this setting$1,588.03RVU18D
2018-07-01Not available in this setting$1,588.03RVU18C
2018-04-01Not available in this setting$1,588.03RVU18B
2018-01-01Not available in this setting$1,588.03RVU18AR1
2017-10-01Not available in this setting$1,573.53RVU17D
2017-07-01Not available in this setting$1,573.53RVU17C
2017-04-01Not available in this setting$1,573.53RVU17B
2017-01-01Not available in this setting$1,573.53RVU17A
2016-10-01Not available in this setting$1,561.82RVU16D
2016-07-01Not available in this setting$1,561.82RVU16C
2016-04-01Not available in this setting$1,561.82RVU16B
2016-01-01Not available in this setting$1,561.82RVU16A
2015-10-01Not available in this setting$1,571.87RVU15D
2015-07-01Not available in this setting$1,571.87RVU15C
2015-04-01Not available in this setting$1,564.04RVU15B
2015-01-01Not available in this setting$1,564.04RVU15A
2014-10-01Not available in this setting$1,534.07RVU14D
2014-07-01Not available in this setting$1,534.07RVU14C
2014-04-01Not available in this setting$1,534.07RVU14B
2014-01-01Not available in this setting$1,534.07RVU14A
2013-10-01Not available in this setting$1,390.48RVU13D
2013-07-01Not available in this setting$1,390.48RVU13C
2013-04-01Not available in this setting$1,390.48RVU13B
2013-01-01Not available in this setting$1,390.48RVU13AR

Price 35246 for an earlier date of service

Where the Oklahoma rate applies

Oklahoma is a Medicare payment area, not a city. Our Census mapping connects it to 846 cities and communities in Oklahoma. Some span more than one payment area; confirm with the service ZIP.

  • Lahoma
  • Achille
  • Ada
  • Adair
  • Adams
  • Adamson
  • Addington
  • Afton

Browse all communities in Oklahoma

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)
Geographic factors for OklahomaGPCI2026.csv, line 86 (RVU26D)

Open CMS sourceHow we calculate rates

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