CPT code 35256: Vessel repair, lower extremity, vein graft2026 Medicare rate & RVUs in Puerto Rico

In Puerto Rico, Medicare pays $926.99 for 35256 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 35256 nationwide

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

What 35256 covers

A surgeon uses this service to reconstruct a blood vessel in the lower limb with a vein graft, such as when an injury or a segmental defect prevents repair by direct suturing. It is typically performed in an operating room by a vascular, trauma, or other surgeon treating the affected vessel. The operative report should identify the lower-extremity site and vessel, describe the defect and repair technique, and document use of a vein graft.

Choose this code for a vein-graft repair in the lower extremity; direct vessel repair is represented by a different code, and repairs using other graft material have a separate code. CMS classifies the service as major surgery with a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery 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.

How Puerto Rico compares for 35256

Across 109 of 109 payment localities, the facility rate for 35256 runs from $816.52 in Wisconsin to $1,180.19 in Alaska. Puerto Rico pays $926.99. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

35256 rates by state

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

See 35256 in every payment locality

How the 35256 rate is calculated

Each of 35256’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 35256

35256 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

Codes related to 35256

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

How 35256 has changed in Puerto Rico

Price 35256 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

• Aceitunas
• Adjuntas
• Aguada
• Aguadilla
• Aguas Buenas
• Aguas Claras
• Aguilita
• Aibonito

Browse all communities in Puerto Rico

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