CPT code 35246: Vessel repair, intrathoracic, without bypass2026 Medicare rate & RVUs in Texas
Reports reconstruction of an intrathoracic blood vessel with a vein graft when the repair restores the vessel without creating a bypass route.
CMS doesn’t publish an office rate for 35246 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 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 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 | $1,480.74 |
| Beaumont, TX | Unavailable | $1,437.35 |
| Brazoria, TX | Unavailable | $1,439.83 |
| Dallas, TX | Unavailable | $1,459.64 |
| Fort Worth, TX | Unavailable | $1,459.05 |
| Galveston, TX | Unavailable | $1,451.08 |
| Houston, TX | Unavailable | $1,571.70 |
| Rest of Texas | Unavailable | $1,445.07 |
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
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
| 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 · 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.
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).
35246 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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
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