CPT code 35266: Vessel repair, upper extremity, nonvein graft2026 Medicare rate & RVUs in Guam
Reports operative reconstruction of an upper-extremity blood vessel using graft material other than a vein, such as for a traumatic vessel defect.
CMS doesn’t publish an office rate for 35266 in Guam.
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 35266 covers
Code 35266 represents operative reconstruction of an injured or surgically damaged upper-extremity blood vessel using graft material other than a vein. A vascular surgeon may use this approach when the vessel defect requires graft reconstruction rather than direct closure; a typical situation is repair of a traumatic arm vessel injury. The code identifies the graft category and upper-extremity site, not a particular named vessel or graft configuration. The service is generally performed in an operating room.
Select this code when the operative report supports both the upper-extremity location and use of nonvein graft material. Document the vessel, defect, graft material, and reconstruction performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires 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.
35266 in Hawaii, Guam, HI
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam, HI | Unavailable | $752.21 |
How the 35266 rate is calculated
Each of 35266’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 · 35266
RVUs × geographic indexes × conversion factor
Work15.43
15.43 RVUs× 1.000 GPCI
Practice expense4.24
4.24 RVUs× 1.000 GPCI
Malpractice3.92
3.92 RVUs× 1.000 GPCI
Adjusted RVUs
23.5900
Conversion factor
$33.4009
Medicare rate
$787.93
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 35266
35266 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 35266
Vessel repair, upper extremity, nonvein graft
| 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 · 35266
Vessel repair, upper extremity, nonvein graft
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
35266 without 50 · national facility
$787.93
Vessel repair, upper extremity, nonvein graft
35266-50 · Bilateral: 150%
$1,181.89
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).
35266 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 35206Vessel repairUpper extremity, direct repair
- 35206 describes direct upper-extremity vessel repair without graft reconstruction. Use 35266 when the repair uses graft material other than a vein.
- 35236Vessel repairUpper extremity, vein graft
- Both codes concern graft repair of an upper-extremity vessel, but 35236 is for a vein graft; 35266 is for other graft material.
- 35286Vessel repairLower extremity, non-vein graft
- 35286 describes nonvein-graft vessel repair in the lower extremity. The distinguishing factor is the anatomical site.
35266 billing questions
When should 35266 be chosen over direct vessel repair?
Use 35266 when the upper-extremity vessel is reconstructed with graft material other than a vein. A direct repair without graft is represented by 35206.
How does a vein graft change the code choice?
For an upper-extremity vessel repair using a vein graft, compare 35236. Code 35266 identifies graft material other than a vein.
What operative documentation supports 35266?
Document the upper-extremity vessel and site, the defect being repaired, the graft material, and how the graft was used in the reconstruction.
How are bilateral procedures and other same-session procedures paid?
CMS pays bilateral reporting with modifier 50 at 150%. For multiple procedures in the same session, the highest-valued procedure is paid in full and the others at 50%.
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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