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Billing code 34502: Cava reconstructionMedicare rate & RVUs

Reports operative reconstruction of the vena cava, such as repair after tumor removal, major injury, or a defect that interrupts normal venous flow.

CMS RVU26DEffective Oct 1, 2026109 payment localities188 Medicare services in 2024

Medicare pays $1,416.53 for 34502 nationally in a facility.

Medicare rate · 34502

Cava reconstruction

Swap in your local Medicare rate.

Work RVUs
27.37
Total RVUs
42.41
Global days
090

National rate · 2026

$1,416.53

Facility setting, before claim adjustments.

See every locality for 34502 → · 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.

On this page 10 sections
  1. Medicare rate
  2. What 34502 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 34502 covers

Code 34502 represents operative rebuilding of the vena cava after a segment is damaged, narrowed, or removed. The surgeon may restore continuity with direct repair, a patch, or an interposition graft, depending on the defect. Typical cases include reconstruction after removal of renal cancer extending into the inferior vena cava or repair after major abdominal trauma. Vascular surgeons and urologic or surgical oncology surgeons perform the procedure in an operating room, often during abdominal or retroperitoneal surgery.

Report the code when the operation includes reconstruction of the vena cava, rather than removal of a clot alone. Document the affected cava segment, defect, reconstruction method and material, and related procedures such as tumor removal. The 90-day global period includes 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 other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for the single vena cava. Assistant-at-surgery payment may be made; co-surgeon and team-surgery payment are 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 34502 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

34502 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,287.48
Alaska*Unavailable$1,796.06
ArizonaUnavailable$1,376.73
ArkansasUnavailable$1,271.94
AtlantaUnavailable$1,466.98
AustinUnavailable$1,410.61
BakersfieldUnavailable$1,377.70
Baltimore/Surr. CntysUnavailable$1,503.00
BeaumontUnavailable$1,375.39
BrazoriaUnavailable$1,374.08

34502 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
34502 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 34502 rate is calculated

Each of 34502’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 · 34502

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 27.37Practice expense 8.62Malpractice 6.42

42.4100 adjusted RVUs×$33.4009 conversion factor=$1,416.53

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 34502

34502 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 34502

Cava reconstruction

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)0Not permitted.
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 · 34502

Cava reconstruction

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

34502 without 51 · national facility

$1,416.53

Cava reconstruction

34502-51 · Second procedure: 50%

$708.27

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

34502 compared with similar codes

Compare codes

34502 vs 35221 vs 35251 vs 35281: national Medicare rates

Swap in your local Medicare rate.

  • 34502
    Cava reconstruction · 27.37 wRVU
    —
  • 35221
    Vessel repair · 25.95 wRVU
    —
  • 35251
    Vessel repair · 31.11 wRVU
    —
  • 35281
    Vessel repair · 29.31 wRVU
    —

How to choose

35221Vessel repair
This code describes direct repair of an intra-abdominal blood vessel generally. Choose 34502 when the reconstructed vessel is the vena cava.
35251Vessel repair
This code describes intra-abdominal vessel repair using a vein graft. Code 34502 specifically identifies vena cava reconstruction.
35281Vessel repair
This code describes intra-abdominal vessel repair using a non-vein graft. Code 34502 is specific to reconstruction of the vena cava.

Codes related to 34502

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

Codes related to 34502
CodeHow it relatesNational office range
Used instead
35221Vessel repairGeneral intra-abdominal vessel repair code for a direct repair in circumstances not represented by this vena-cava code.No office rate
35251Vessel repairGeneral intra-abdominal vessel repair code involving a vein graft, for circumstances not represented by this vena-cava code.No office rate
35281Vessel repairGeneral intra-abdominal vessel repair code involving a non-vein graft, for circumstances not represented by this vena-cava code.No office rate

34502 billing questions

When is 34502 appropriate instead of a general vessel-repair code?

Use 34502 when the operation reconstructs the vena cava. General intra-abdominal vessel-repair codes describe other vessels or circumstances and should not replace this vena-cava-specific code.

Does removal of a vena cava clot alone support 34502?

No. The operative report should show that the vena cava was reconstructed, not merely that a thrombus was removed.

Can 34502 be reported with tumor removal?

It may be performed during an operation removing a tumor involving the vena cava. Document the reconstruction as a distinct operative service and describe its relationship to the tumor procedure.

Should modifier 50 be used for vena cava reconstruction?

No. Modifier 50 is inappropriate for the single vena cava.

What postoperative care is included in the global period?

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

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made for 34502. Co-surgeon and team-surgery payment are 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 34502PPRRVU2026_Oct_nonQPP.csv, line 4,194 (RVU26D)

Open CMS sourceHow we calculate rates

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