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Billing code 35251: Vessel repairMedicare rate & RVUs

Reports operative repair of an intra-abdominal blood vessel using a vein graft, such as during reconstruction after vessel injury or resection.

CMS RVU26DEffective Oct 1, 2026109 payment localities189 Medicare services in 2024

Medicare pays $1,565.50 for 35251 nationally in a facility.

Medicare rate · 35251

Vessel repair

Work RVUs
31.11
Total RVUs
46.87
Global days
090

National rate · 2026

$1,565.50

Facility setting, before claim adjustments.

See every locality for 35251 →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 35251 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 35251 covers

This code describes surgical reconstruction of a blood vessel within the abdomen when the repair uses a vein graft. Vascular surgeons commonly perform it during open abdominal operations for vessel injury or when a segment must be reconstructed after disease or tumor resection. The operative report should identify the vessel and its abdominal location, the defect or reason for reconstruction, and the vein graft used.

Select this code when the documented repair uses a vein graft; a direct repair or repair using another graft material belongs to a different code. The procedure has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 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 35251 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

35251 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,418.68
Alaska*Unavailable$1,984.50
ArizonaUnavailable$1,519.55
ArkansasUnavailable$1,401.08
AtlantaUnavailable$1,625.55
AustinUnavailable$1,553.01
BakersfieldUnavailable$1,508.09
Baltimore/Surr. CntysUnavailable$1,663.55
BeaumontUnavailable$1,523.11
BrazoriaUnavailable$1,513.75

35251 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
35251 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 35251 rate is calculated

Each of 35251’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 · 35251

RVUs × geographic indexes × conversion factor

Work31.11

31.11 RVUs× 1.000 GPCI

Practice expense7.91

7.91 RVUs× 1.000 GPCI

Malpractice7.85

7.85 RVUs× 1.000 GPCI

Adjusted RVUs

46.8700

Conversion factor

$33.4009

Medicare rate

$1,565.50

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

Payment rules and modifiers for 35251

35251 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 35251

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 · 35251

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.

  • 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

35251 without 50 · national facility

$1,565.50

Vessel repair

35251-50 · Bilateral: 150%

$2,348.25

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

35251 compared with similar codes

Compare codes · National

4 codes, side by side

  • 35251

    Vessel repair31.11 wRVU

    Not priced

  • 35221

    Vessel repair25.95 wRVU

    Not priced

  • 35281

    Vessel repair29.31 wRVU

    Not priced

  • 35231

    Vascular repair20.63 wRVU

    Not priced

How to choose

35221Vessel repair
Both address intra-abdominal vessel repair, but 35221 is for direct repair. Choose 35251 when the operative report documents a vein graft.
35281Vessel repair
Both are intra-abdominal vessel repairs using a graft; 35251 specifies a vein graft, while 35281 is for another graft material.
35231Vascular repair
This is the corresponding vein-graft repair code for a vessel in the neck. The abdominal location distinguishes 35251.

Codes related to 35251

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

Codes related to 35251
CodeHow it relatesNational office range
Used instead
35221Vessel repairIntra-abdominal vessel repair by direct technique rather than with a vein graft.No office rate
35281Vessel repairIntra-abdominal vessel repair using a graft other than a vein graft.No office rate
Same family
35231Vascular repairVein-graft vessel repair in the neck rather than the abdomen.No office rate
35241Vascular repairVein-graft vessel repair in the chest rather than the abdomen.No office rate
35256Vessel repairVein-graft vessel repair in an extremity rather than the abdomen.No office rate

35251 billing questions

How does this differ from 35221?

This code is for an intra-abdominal vessel repair using a vein graft. Code 35221 describes direct repair without a graft.

When would 35281 be considered instead?

Use 35281 when the intra-abdominal vessel repair uses a graft other than a vein graft. The operative report should support the graft material used.

What documentation supports reporting this code?

Document the abdominal vessel repaired, the reason for reconstruction, and that a vein graft was used. The operative details should distinguish graft reconstruction from direct closure.

How is the 90-day global period applied?

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

How are multiple procedures and bilateral reporting handled?

For procedures in the same session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%.

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
RVUs for 35251PPRRVU2026_Oct_nonQPP.csv, line 4,304 (RVU26D)

Open CMS sourceHow we calculate rates

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