CPT code 35331: Arterial endarterectomy, aortoiliac segment2026 Medicare rate & RVUs

Medicare pays $1,270.90 for 35331 nationally in a facility.

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

What 35331 covers

A vascular surgeon performs this open operation to remove atherosclerotic material obstructing the aortoiliac arterial pathway. It is used for selected patients with aortoiliac occlusive disease causing symptoms such as limiting claudication or limb-threatening ischemia. The surgeon may use a patch to widen the treated vessel; that possibility is included in the procedure. The service is generally performed in a hospital operating room, rather than an office setting.

Report the code when the operative work is an endarterectomy involving the aortoiliac segment. The operative note should identify the treated artery or arteries, laterality, extent of plaque removal, and any patch repair. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during the 90 days after surgery. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting 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 35331 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

35331 rates by state

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

How the 35331 rate is calculated

Each of 35331’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 35331

35331 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

35331 compared with similar codes

How to choose

35321Arterial endarterectomyAxillary-brachial artery

35321 is for endarterectomy limited to the aorta. Report 35331 when the operative treatment involves the aortoiliac segment.

35341Arterial endarterectomyAbdominal branch artery

35341 represents endarterectomy in a different arterial territory. Base code selection on the vessels actually treated, as documented in the operative report.

35646Aortic bypassTo both femoral arteries

35646 describes an aortobifemoral bypass, not aortoiliac plaque removal. Choose according to whether the surgeon performed bypass or endarterectomy.

Codes related to 35331

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

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