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Billing code 35216: Vessel repairMedicare rate & RVUs

Report this code for direct surgical repair of a blood vessel in the chest when the repair is performed without bypass.

CMS RVU26DEffective Oct 1, 2026109 payment localities248 Medicare services in 2024

Medicare pays $1,907.53 for 35216 nationally in a facility.

Medicare rate · 35216

Vessel repair

Swap in your local Medicare rate.

Work RVUs
35.69
Total RVUs
57.11
Global days
090

National rate · 2026

$1,907.53

Facility setting, before claim adjustments.

See every locality for 35216 → · 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 35216 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 35216 covers

This service covers direct operative repair of an intrathoracic blood vessel, such as repair of a vessel injured during chest trauma or another thoracic operation. A cardiothoracic or vascular surgeon typically performs it in an operating room as part of a major procedure. The repair addresses the vessel itself without a bypass; it is distinct from repair using a vein graft or another graft method.

Select the code based on the operative site, direct repair method, and whether bypass was used. The operative report should identify the vessel and chest location and describe the repair and any bypass or graft. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures at 50%. Modifier 50 identifies bilateral performance, paid at 150%. Assistant-at-surgery payment may be made; 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 35216 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

35216 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,729.33
Alaska*Unavailable$2,402.42
ArizonaUnavailable$1,852.89
ArkansasUnavailable$1,707.83
AtlantaUnavailable$1,975.69
AustinUnavailable$1,902.00
BakersfieldUnavailable$1,858.97
Baltimore/Surr. CntysUnavailable$2,025.93
BeaumontUnavailable$1,848.59
BrazoriaUnavailable$1,850.01

35216 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

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
35216 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 35216 rate is calculated

Each of 35216’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 · 35216

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 35.69Practice expense 12.82Malpractice 8.60

57.1100 adjusted RVUs×$33.4009 conversion factor=$1,907.53

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

Payment rules and modifiers for 35216

35216 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 35216

Vessel 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 · 35216

Vessel 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

35216 without 50 · national facility

$1,907.53

Vessel repair

35216-50 · Bilateral: 150%

$2,861.30

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

35216 compared with similar codes

Compare codes

35216 vs 35211 vs 35246 vs 35221: national Medicare rates

Swap in your local Medicare rate.

  • 35216
    Vessel repair · 35.69 wRVU
    —
  • 35211
    Vessel repair · 23.97 wRVU
    —
  • 35246
    Vessel repair · 27.52 wRVU
    —
  • 35221
    Vessel repair · 25.95 wRVU
    —

How to choose

35211Vessel repair
Choose 35216 for direct intrathoracic repair without bypass; choose 35211 when bypass is used.
35246Vessel repair
35216 describes direct repair without a graft, while 35246 is for intrathoracic repair using a vein graft without bypass.
35221Vessel repair
Both are direct repairs without bypass, but 35221 applies to an intra-abdominal vessel rather than an intrathoracic vessel.

Codes related to 35216

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

Codes related to 35216
CodeHow it relatesNational office range
Same family
35211Vessel repairDirect intrathoracic repair when bypass is used.No office rate
35201Vessel repairDirect vessel repair in the neck rather than the chest.No office rate
35221Vessel repairDirect vessel repair in the intra-abdominal region.No office rate
Used instead
35246Vessel repairIntrathoracic repair using a vein graft without bypass.No office rate

35216 billing questions

How is 35216 different from 35211?

Both describe direct intrathoracic vessel repair, but 35216 is for repair without bypass. Use 35211 when the repair includes bypass.

When should a vein-graft repair be considered instead?

If the surgeon repairs the intrathoracic vessel using a vein graft, compare 35246 rather than reporting the direct-repair code.

What documentation supports 35216?

The operative report should identify the vessel and intrathoracic site and describe the direct repair, including whether bypass or a graft was used.

How does CMS handle bilateral reporting?

For bilateral performance, report modifier 50; CMS pays the bilateral procedure at 150%.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, and 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 35216PPRRVU2026_Oct_nonQPP.csv, line 4,297 (RVU26D)

Open CMS sourceHow we calculate rates

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