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Billing code 35021: Arterial repairMedicare rate & RVUs

Direct repair of an arterial wall defect in the chest is reported for operative treatment of an intrathoracic artery defect.

CMS RVU26DEffective Oct 1, 2026109 payment localities21 Medicare services in 2024

Medicare pays $1,209.11 for 35021 nationally in a facility.

Medicare rate · 35021

Arterial repair

Swap in your local Medicare rate.

Work RVUs
21.62
Total RVUs
36.20
Global days
090

National rate · 2026

$1,209.11

Facility setting, before claim adjustments.

See every locality for 35021 → · 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 35021 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 35021 covers

This code describes a surgeon’s direct repair of an arterial wall defect in the chest. It is selected for an intrathoracic artery rather than a neck or limb artery; the specific vessel and defect should be clear in the operative report. Vascular surgeons typically perform the service in a hospital operating room as part of an open procedure.

The record should identify the artery, the defect repaired, and the work performed. This major surgery code includes the preoperative visit on the day before surgery 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 50% multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation. 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 35021 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

35021 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,094.98
Alaska*Unavailable$1,513.24
ArizonaUnavailable$1,174.54
ArkansasUnavailable$1,081.16
AtlantaUnavailable$1,250.96
AustinUnavailable$1,209.16
BakersfieldUnavailable$1,185.65
Baltimore/Surr. CntysUnavailable$1,284.48
BeaumontUnavailable$1,168.56
BrazoriaUnavailable$1,174.14

35021 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
35021 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 35021 rate is calculated

Each of 35021’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 · 35021

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 21.62Practice expense 9.42Malpractice 5.16

36.2000 adjusted RVUs×$33.4009 conversion factor=$1,209.11

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

Payment rules and modifiers for 35021

35021 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 35021

Arterial repair

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 · 35021

Arterial repair

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 50 · payment effect

With and without the modifier

35021 without 50 · national facility

$1,209.11

Arterial repair

35021-50 · Bilateral: 150%

$1,813.66

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

35021 compared with similar codes

Compare codes

35021 vs 35022 vs 35091 vs 35001: national Medicare rates

Swap in your local Medicare rate.

  • 35021
    Arterial repair · 21.62 wRVU
    —
  • 35022
    Arterial repair · 25.06 wRVU
    —
  • 35091
    Artery repair · 34.47 wRVU
    —
  • 35001
    Arterial repair · 20.29 wRVU
    —

How to choose

35022Arterial repair
Choose 35022 when the service is repair of an artery rupture in the chest. This code describes direct repair of an intrathoracic arterial defect.
35091Artery repair
35091 is for a defect of the thoracic aorta. Use this code for the direct repair of a defect in another intrathoracic artery.
35001Arterial repair
35001 identifies direct repair of an arterial defect in the neck; this code identifies an intrathoracic site.

Codes related to 35021

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

Codes related to 35021
CodeHow it relatesNational office range
Same family
35022Arterial repairIntrathoracic artery rupture repair; distinguishes rupture from the defect repair represented here.No office rate
35001Arterial repairDirect repair of an arterial defect in the neck.No office rate
35005Artery repairDirect repair of an arterial defect in an upper extremity.No office rate
35011Artery repairDirect repair of an arterial defect in a lower extremity.No office rate
Used instead
35091Artery repairUse for a thoracic aortic defect rather than another intrathoracic artery.No office rate

35021 billing questions

How is this distinguished from 35022?

35021 is for direct repair of an intrathoracic arterial defect. 35022 identifies repair of an artery rupture in the chest.

What should the operative report document?

Document the intrathoracic artery involved, the defect repaired, and the direct repair performed. This supports choosing the chest-vessel service rather than a neck or limb artery code.

Can modifier 50 be used for bilateral repair?

When the procedure is performed bilaterally, CMS pays the service reported with modifier 50 at 150%.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures in that session are subject to the standard 50% multiple-procedure reduction.

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 35021PPRRVU2026_Oct_nonQPP.csv, line 4,258 (RVU26D)

Open CMS sourceHow we calculate rates

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