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CPT code 35903: Graft excision, extremity site2026 Medicare rate & RVUs

Removal of an infected vascular graft in an arm or leg, reported when surgery excises the graft to address the infection.

CMS RVU26DEffective Oct 1, 2026109 payment localities3.4K Medicare services in 2024

Medicare pays $518.05 for 35903 nationally in a facility.

Medicare rate · 35903

Graft excision, extremity site

Office or facility?

Work RVUs
9.29
Total RVUs
15.51
Global days
090

National rate · 2026

$518.05

Facility setting, before claim adjustments.

See every locality for 35903 →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 35903 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 35903 covers

Code 35903 describes surgical excision of an infected vascular graft located in an extremity. A vascular surgeon commonly performs the operation in a hospital operating room, such as when an infected peripheral arterial bypass graft must be removed. The code is selected by the graft’s anatomic location; it is not the code for an infected graft in the neck, chest, or abdomen.

Report the code when the operative documentation supports excision of the extremity graft, including its site and the infection prompting surgery. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. 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 multiple procedure reduction. Modifier 50 is inappropriate for this site-specific service. An assistant at surgery 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 35903 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

35903 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$467.62
AlaskaUnavailable$646.01
ArizonaUnavailable$502.66
ArkansasUnavailable$461.52
Atlanta, GAUnavailable$536.95
Austin, TXUnavailable$517.10
Bakersfield, CAUnavailable$505.34
Baltimore area, MDUnavailable$551.16
Beaumont, TXUnavailable$500.85
Brazoria, TXUnavailable$501.96

35903 rates by state

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

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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
35903 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 35903 rate is calculated

Each of 35903’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 · 35903

RVUs × geographic indexes × conversion factor

Office or facility?

Work9.29

9.29 RVUs× 1.000 GPCI

Practice expense3.85

3.85 RVUs× 1.000 GPCI

Malpractice2.37

2.37 RVUs× 1.000 GPCI

Adjusted RVUs

15.5100

Conversion factor

$33.4009

Medicare rate

$518.05

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

Payment rules and modifiers for 35903

35903 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 35903

Graft excision, extremity site

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)0The 150% bilateral adjustment doesn’t apply.
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 · 35903

Graft excision, extremity site

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 51 · payment effect

With and without the modifier

35903 without 51 · national facility

$518.05

Graft excision, extremity site

35903-51 · Second procedure: 50%

$259.03

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

35903 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 35903

    Graft excision, extremity site9.29 wRVU

    Not priced

  • 35901

    Graft excision, neck site8.17 wRVU

    Not priced

  • 35905

    Graft excision, thoracic site32.68 wRVU

    Not priced

  • 35907

    Graft excision, abdominal location36.34 wRVU

    Not priced

How to choose

35901Graft excisionNeck site
Use 35901 when the infected graft being excised is in the neck; 35903 is for an extremity graft.
35905Graft excisionThoracic site
Use 35905 for an infected graft in the thorax. The extremity location supports 35903.
35907Graft excisionAbdominal location
Use 35907 for an infected graft in the abdomen; 35903 identifies excision at an extremity site.

Codes related to 35903

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

Codes related to 35903
CodeHow it relatesNational office range
Same family
35901Graft excision, neck siteSite-specific sibling for excision of an infected graft in the neck.No office rate
35905Graft excision, thoracic siteSite-specific sibling for excision of an infected graft in the thorax.No office rate
35907Graft excision, abdominal locationSite-specific sibling for excision of an infected graft in the abdomen.No office rate

35903 billing questions

How is 35903 distinguished from 35905?

Choose 35903 for an infected graft in an extremity. Code 35905 identifies an infected graft in the thorax.

What documentation supports reporting 35903?

The operative report should establish the graft’s extremity location and document that the graft was excised to address infection.

Does the 90-day global period include postoperative care?

Yes. It includes the day-before preoperative visit and 90 days of related postoperative care.

Should modifier 50 be used for grafts in both extremities?

No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.

Can an assistant or co-surgeon be reported?

An assistant at surgery 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 35903PPRRVU2026_Oct_nonQPP.csv, line 4,427 (RVU26D)

Open CMS sourceHow we calculate rates

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