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Billing code 35092: Aortic rupture repairMedicare rate & RVUs

Open operative repair of a ruptured thoracoabdominal aortic aneurysm, reported when the rupture involves the aorta across the chest and abdomen.

CMS RVU26DEffective Oct 1, 2026109 payment localities82 Medicare services in 2024

Medicare pays $2,291.30 for 35092 nationally in a facility.

Medicare rate · 35092

Aortic rupture repair

Work RVUs
49.7
Total RVUs
68.60
Global days
090

National rate · 2026

$2,291.30

Facility setting, before claim adjustments.

See every locality for 35092 →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 35092 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 35092 covers

This code represents open repair of a ruptured aneurysm involving the thoracoabdominal aorta, typically with reconstruction of the affected aortic segment using a graft. Vascular or cardiothoracic surgeons perform this major operation in a hospital operating room, generally as an emergency for a patient with acute aortic rupture. The operative report should establish the rupture and describe the aortic extent and reconstruction performed.

Select this code when the ruptured aneurysm involves the thoracoabdominal aorta; an abdominal-only rupture is represented by a different code. CMS assigns a 90-day global period, including 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 at 50%. Modifier 50 bilateral reporting is paid at 150%. 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 35092 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

35092 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$2,081.21
Alaska*Unavailable$2,944.14
ArizonaUnavailable$2,223.76
ArkansasUnavailable$2,056.25
AtlantaUnavailable$2,384.92
AustinUnavailable$2,258.22
BakersfieldUnavailable$2,176.70
Baltimore/Surr. CntysUnavailable$2,433.57
BeaumontUnavailable$2,242.55
BrazoriaUnavailable$2,209.33

35092 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
35092 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 35092 rate is calculated

Each of 35092’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 · 35092

RVUs × geographic indexes × conversion factor

Work49.70

49.70 RVUs× 1.000 GPCI

Practice expense6.19

6.19 RVUs× 1.000 GPCI

Malpractice12.71

12.71 RVUs× 1.000 GPCI

Adjusted RVUs

68.6000

Conversion factor

$33.4009

Medicare rate

$2,291.30

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

Payment rules and modifiers for 35092

35092 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 35092

Aortic rupture 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 · 35092

Aortic rupture 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.

  • 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 50 · payment effect

With and without the modifier

35092 without 50 · national facility

$2,291.30

Aortic rupture repair

35092-50 · Bilateral: 150%

$3,436.95

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

35092 compared with similar codes

Compare codes · National

4 codes, side by side

  • 35092

    Aortic rupture repair49.7 wRVU

    Not priced

  • 35082

    Aortic rupture repair41.04 wRVU

    Not priced

  • 35091

    Artery repair34.47 wRVU

    Not priced

  • 35081

    Aortic aneurysm repair32.69 wRVU

    Not priced

How to choose

35082Aortic rupture repair
Choose 35092 when the rupture involves the thoracoabdominal aorta; choose 35082 when the repair concerns a ruptured aneurysm of the abdominal aorta.
35091Artery repair
Both codes concern the thoracoabdominal aorta. The distinguishing factor is rupture: 35092 is for a ruptured aneurysm, while 35091 is for a nonruptured aneurysm.
35081Aortic aneurysm repair
35081 describes nonruptured aneurysm repair involving the abdominal aorta; 35092 describes rupture repair involving the thoracoabdominal aorta.

Codes related to 35092

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

Codes related to 35092
CodeHow it relatesNational office range
Same family
35082Aortic rupture repairRupture repair involving the abdominal aorta rather than the thoracoabdominal aorta.No office rate
35091Artery repairThoracoabdominal aortic aneurysm repair when the aneurysm is not ruptured.No office rate
35081Aortic aneurysm repairNonruptured aneurysm repair involving the abdominal aorta.No office rate
35022Arterial repairRupture repair involving the chest aorta rather than the thoracoabdominal segment.No office rate

35092 billing questions

How is this code distinguished from 35082?

Use 35092 for a ruptured aneurysm involving the thoracoabdominal aorta. Code 35082 describes rupture repair involving the abdominal aorta.

How does 35092 differ from 35091?

Both concern the thoracoabdominal aorta, but 35092 is for rupture repair. Code 35091 is for repair of an aneurysm that is not ruptured.

What postoperative care is included?

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?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; CMS does not permit team surgery for this code.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures are paid at 50% under the standard multiple procedure reduction.

How is bilateral reporting handled?

When reported bilaterally with modifier 50, CMS pays this procedure at 150%.

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 35092PPRRVU2026_Oct_nonQPP.csv, line 4,266 (RVU26D)

Open CMS sourceHow we calculate rates

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