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Billing code 35261: Vessel repairMedicare rate & RVUs

Reports open reconstruction of a neck blood vessel using a graft other than a vein, such as when vessel damage requires graft repair.

CMS RVU26DEffective Oct 1, 2026109 payment localities76 Medicare services in 2024

Medicare pays $897.48 for 35261 nationally in a facility.

Medicare rate · 35261

Vessel repair

Swap in your local Medicare rate.

Work RVUs
18.49
Total RVUs
26.87
Global days
090

National rate · 2026

$897.48

Facility setting, before claim adjustments.

See every locality for 35261 → · 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 35261 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 35261 covers

A surgeon uses this service to reconstruct a blood vessel in the neck with a graft made from material other than a vein. A carotid artery repair using a non-vein graft is a representative situation. The work is typically performed in an operating room by a vascular surgeon or another surgeon managing a neck vascular injury or defect. The operative report should identify the vessel, the neck location, and the graft used.

Choose this code when the neck vessel repair requires a non-vein graft, rather than direct vessel repair or a vein graft. The documentation should support the graft-based reconstruction and distinguish it from other repairs performed during the same session. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one 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%. Assistant-at-surgery payment may be allowed; 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 35261 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

35261 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$813.68
Alaska*Unavailable$1,143.26
ArizonaUnavailable$870.95
ArkansasUnavailable$803.67
AtlantaUnavailable$933.04
AustinUnavailable$887.78
BakersfieldUnavailable$859.15
Baltimore/Surr. CntysUnavailable$953.71
BeaumontUnavailable$875.29
BrazoriaUnavailable$866.57

35261 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
35261 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 35261 rate is calculated

Each of 35261’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 · 35261

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 18.49Practice expense 3.65Malpractice 4.73

26.8700 adjusted RVUs×$33.4009 conversion factor=$897.48

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

Payment rules and modifiers for 35261

35261 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 35261

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 · 35261

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

35261 without 50 · national facility

$897.48

Vessel repair

35261-50 · Bilateral: 150%

$1,346.22

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

35261 compared with similar codes

Compare codes

35261 vs 35201 vs 35231 vs 35266: national Medicare rates

Swap in your local Medicare rate.

  • 35261
    Vessel repair · 18.49 wRVU
    —
  • 35201
    Vessel repair · 16.51 wRVU
    —
  • 35231
    Vascular repair · 20.63 wRVU
    —
  • 35266
    Vessel repair · 15.43 wRVU
    —

How to choose

35201Vessel repair
35201 describes direct neck-vessel repair without a graft. Choose 35261 when the neck vessel is reconstructed using a graft other than a vein.
35231Vascular repair
Both involve graft repair of a neck vessel, but 35231 specifies a vein graft. Use 35261 for a graft other than a vein.
35266Vessel repair
35266 is the corresponding non-vein graft repair for a vessel in the upper extremity. The repaired vessel's location determines whether 35261 or 35266 applies.

Codes related to 35261

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

Codes related to 35261
CodeHow it relatesNational office range
Used instead
35201Vessel repairDirect neck-vessel repair without graft reconstruction.No office rate
35231Vascular repairNeck-vessel graft repair using a vein rather than another graft material.No office rate
Same family
35266Vessel repairNon-vein graft repair in the upper extremity rather than the neck.No office rate
35271Vascular graft repairNon-vein graft repair in the intrathoracic region.No office rate
35281Vessel repairNon-vein graft repair in the intra-abdominal region.No office rate
35286Vessel repairNon-vein graft repair in the lower extremity.No office rate

35261 billing questions

How does this differ from 35231?

Both codes describe graft repair of a neck blood vessel. Use 35261 for a graft other than a vein; 35231 is for a vein graft.

When is 35201 a better fit?

Use 35201 for direct repair of a neck blood vessel without graft reconstruction. Use 35261 when the documented repair uses a non-vein graft.

What should the operative report document?

Document the neck vessel repaired, the need for graft reconstruction, and that the graft material was other than a vein. The report should also distinguish the repair from any separate procedures performed in the same session.

How does the 90-day global period affect follow-up billing?

The day-before preoperative visit and 90 days of related postoperative care are included in the global period. Unrelated services require documentation supporting their separate nature.

How are multiple procedures and bilateral repairs handled?

For multiple procedures in the same session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. CMS pays bilateral reporting with modifier 50 at 150%.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be allowed. 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 35261PPRRVU2026_Oct_nonQPP.csv, line 4,306 (RVU26D)

Open CMS sourceHow we calculate rates

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