CPT code 35903: Graft excision, extremity site2026 Medicare rate & RVUs in Missouri
Removal of an infected vascular graft in an arm or leg, reported when surgery excises the graft to address the infection.
CMS doesn’t publish an office rate for 35903 in Missouri.
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 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 in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $508.38 |
| Metropolitan St. Louis, MO | Unavailable | $512.03 |
| Rest of Missouri | Unavailable | $498.24 |
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
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
| 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| 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 · 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.
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%).
35903 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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
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