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CPT code 35281: Vessel repair, nonvenous graft, intra-abdominal2026 Medicare rate & RVUs

Open reconstruction of an intra-abdominal blood vessel using a graft other than a vein, reported when the operative repair uses graft material.

CMS RVU26DEffective Oct 1, 2026109 payment localities170 Medicare services in 2024

Medicare pays $1,485.67 for 35281 nationally in a facility.

Medicare rate · 35281

Vessel repair, nonvenous graft, intra-abdominal

Office or facility?

Work RVUs
29.31
Total RVUs
44.48
Global days
090

National rate · 2026

$1,485.67

Facility setting, before claim adjustments.

See every locality for 35281 →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 35281 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 35281 covers

A surgeon reconstructs an intra-abdominal blood vessel using graft material other than a vein. The repair may involve a major vessel such as the aorta or an abdominal branch vessel. Vascular surgeons commonly perform this work in an operating room during planned reconstruction or urgent treatment of vessel injury. The operative report should identify the vessel and its intra-abdominal location, describe the graft used, and explain the reconstruction performed.

Report this code when the documented repair uses a nonvenous graft; a direct repair or a repair using a vein graft is represented by a different code. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others are reduced to 50%. A bilateral procedure reported with modifier 50 is paid at 150%. Assistant-at-surgery services may be paid; 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.

Where 35281 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

35281 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,345.24
AlaskaUnavailable$1,879.85
ArizonaUnavailable$1,441.77
ArkansasUnavailable$1,328.40
Atlanta, GAUnavailable$1,542.87
Austin, TXUnavailable$1,474.10
Bakersfield, CAUnavailable$1,431.41
Baltimore area, MDUnavailable$1,579.24
Beaumont, TXUnavailable$1,444.81
Brazoria, TXUnavailable$1,436.30

35281 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
35281 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 35281 rate is calculated

Each of 35281’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 · 35281

RVUs × geographic indexes × conversion factor

Office or facility?

Work29.31

29.31 RVUs× 1.000 GPCI

Practice expense7.70

7.70 RVUs× 1.000 GPCI

Malpractice7.47

7.47 RVUs× 1.000 GPCI

Adjusted RVUs

44.4800

Conversion factor

$33.4009

Medicare rate

$1,485.67

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

Payment rules and modifiers for 35281

35281 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 35281

Vessel repair, nonvenous graft, intra-abdominal

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 · 35281

Vessel repair, nonvenous graft, intra-abdominal

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

35281 without 50 · national facility

$1,485.67

Vessel repair, nonvenous graft, intra-abdominal

35281-50 · Bilateral: 150%

$2,228.51

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

35281 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 35281

    Vessel repair, nonvenous graft, intra-abdominal29.31 wRVU

    Not priced

  • 35221

    Vessel repair, direct repair, intra-abdominal25.95 wRVU

    Not priced

  • 35251

    Vessel repair, intra-abdominal vein graft31.11 wRVU

    Not priced

  • 35276

    Vessel repair, intrathoracic, without bypass25.18 wRVU

    Not priced

How to choose

35221Vessel repairDirect repair, intra-abdominal
35221 describes direct repair of an intra-abdominal vessel without a graft. Choose 35281 when the operative repair uses graft material other than a vein.
35251Vessel repairIntra-abdominal vein graft
Both codes concern intra-abdominal vessel repair with a graft; 35251 specifies a vein graft, while 35281 is for graft material other than a vein.
35276Vessel repairIntrathoracic, without bypass
Both involve nonvenous graft repair, but 35276 is for an intrathoracic vessel without bypass. 35281 is for an intra-abdominal vessel.

Codes related to 35281

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

Codes related to 35281
CodeHow it relatesNational office range
Used instead
35221Vessel repair, direct repair, intra-abdominalDirect intra-abdominal vessel repair without a graft.No office rate
35251Vessel repair, intra-abdominal vein graftIntra-abdominal vessel repair using a vein graft.No office rate
Same family
35271Vascular graft repair, intrathoracic, with bypassNonvenous graft repair at an intrathoracic site with bypass.No office rate
35276Vessel repair, intrathoracic, without bypassNonvenous graft repair at an intrathoracic site without bypass.No office rate
35286Vessel repair, lower extremity, non-vein graftNonvenous graft repair at a lower-extremity site.No office rate

35281 billing questions

How is 35281 different from 35251?

Both describe intra-abdominal vessel reconstruction using a graft, but 35281 is for graft material other than a vein. Use 35251 when the repair uses a vein graft.

When would 35221 be more appropriate?

Use 35221 for direct intra-abdominal vessel repair without a graft. The operative report must support use of graft material for 35281.

What operative details support 35281?

Document the vessel and its intra-abdominal location, the graft material, and the reconstructive work performed. These details distinguish this service from direct repair and vein-graft repair.

How does the 90-day global period affect postoperative billing?

The day-before preoperative visit and 90 days of related postoperative care are included in the global period.

How are multiple procedures and bilateral reporting handled?

For multiple procedures in the same session, the highest-valued procedure is paid in full and the others at 50%. A bilateral procedure reported with modifier 50 is paid at 150%.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

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 35281PPRRVU2026_Oct_nonQPP.csv, line 4,310 (RVU26D)

Open CMS sourceHow we calculate rates

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