No office rate
Use 35190 for an acquired extremity fistula; 35184 identifies a congenital extremity fistula.
On this page
CMS RVU26D · Effective 2026-10-01
35190 in El Centro
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$655.49
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Vascular surgery
About 35190: Acquired extremity arteriovenous fistula repair
Reports operative repair of an acquired artery-to-vein connection in an extremity, such as a fistula resulting from trauma or a prior procedure.
This code covers surgical repair of an acquired abnormal connection between an artery and a vein in an arm or leg. A vascular surgeon typically performs the operation in a hospital or other surgical facility, exposing and controlling the involved vessels before closing or reconstructing the communication. Acquired fistulas may follow trauma or a vascular intervention; the documented site and acquired nature distinguish this service from repair of a congenital fistula or one in another body region.
Report the code when the operative record supports repair of an acquired extremity fistula, including the affected vessels, location, and work performed. It has a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. 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. Modifier 50 is inappropriate under the bilateral rule. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 35190
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU13.08 · 64%
- Practice expense (office) RVU4.12 · 20%
- Malpractice RVU3.34 · 16%
213
Medicare services in 2024 · #4266 by national volume
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.
35190 compared with similar codes
Office rates for El Centro, from the same CMS release.
No office rate
Both codes concern acquired fistulas, but 35188 is for the head or neck rather than an extremity.
No office rate
Both codes concern acquired fistulas, but 35189 is for the thorax or abdomen rather than an extremity.
The same code, a different location
How does El Centro compare?
35190 across payment areas
Same release and payment basis · bars start at $0
El Centro · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Merced
California · 35190
Office
Unavailable
Facility
$654.93
No comparable office rate is available.
Modesto
California · 35190
Office
Unavailable
Facility
$654.93
No comparable office rate is available.
Napa
California · 35190
Office
Unavailable
Facility
$702.45
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 35190
Office
Unavailable
Facility
$681.27
No comparable office rate is available.
Redding
California · 35190
Office
Unavailable
Facility
$654.93
No comparable office rate is available.
Rest Of California
California · 35190
Office
Unavailable
Facility
$654.93
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 35190
Office
Unavailable
Facility
$690.73
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 35190
Office
Unavailable
Facility
$672.45
No comparable office rate is available.
Salinas
California · 35190
Office
Unavailable
Facility
$669.71
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 35190
Office
Unavailable
Facility
$675.04
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 35190
Office
Unavailable
Facility
$723.63
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 35190
Office
Unavailable
Facility
$719.83
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 35190
Office
Unavailable
Facility
$743.17
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 35190
Office
Unavailable
Facility
$727.67
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 35190
Office
Unavailable
Facility
$660.85
No comparable office rate is available.
Santa Cruz-Watsonville
California · 35190
Office
Unavailable
Facility
$673.05
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 35190
Office
Unavailable
Facility
$669.37
No comparable office rate is available.
Santa Rosa-Petaluma
California · 35190
Office
Unavailable
Facility
$678.77
No comparable office rate is available.
Stockton
California · 35190
Office
Unavailable
Facility
$654.93
No comparable office rate is available.
Vallejo
California · 35190
Office
Unavailable
Facility
$696.99
No comparable office rate is available.
Visalia
California · 35190
Office
Unavailable
Facility
$654.93
No comparable office rate is available.
Yuba City
California · 35190
Office
Unavailable
Facility
$654.93
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 35190
Office
Unavailable
Facility
$746.75
No comparable office rate is available.
Miami
Florida · 35190
Office
Unavailable
Facility
$862.27
No comparable office rate is available.
Chicago
Illinois · 35190
Office
Unavailable
Facility
$834.27
No comparable office rate is available.
Manhattan
New York · 35190
Office
Unavailable
Facility
$801.68
No comparable office rate is available.
Alaska*
Alaska · 35190
Office
Unavailable
Facility
$863.35
No comparable office rate is available.
Alabama
Alabama · 35190
Office
Unavailable
Facility
$620.44
No comparable office rate is available.
Arkansas
Arkansas · 35190
Office
Unavailable
Facility
$612.55
No comparable office rate is available.
Arizona
Arizona · 35190
Office
Unavailable
Facility
$665.72
No comparable office rate is available.
Colorado
Colorado · 35190
Office
Unavailable
Facility
$675.67
No comparable office rate is available.
Connecticut
Connecticut · 35190
Office
Unavailable
Facility
$728.82
No comparable office rate is available.
Delaware
Delaware · 35190
Office
Unavailable
Facility
$675.32
No comparable office rate is available.
Fort Lauderdale
Florida · 35190
Office
Unavailable
Facility
$777.98
No comparable office rate is available.
Rest Of Florida
Florida · 35190
Office
Unavailable
Facility
$736.11
No comparable office rate is available.
Atlanta
Georgia · 35190
Office
Unavailable
Facility
$711.99
No comparable office rate is available.
Rest Of Georgia
Georgia · 35190
Office
Unavailable
Facility
$692.61
No comparable office rate is available.
Hawaii, Guam
Hawaii · 35190
Office
Unavailable
Facility
$657.94
No comparable office rate is available.
Iowa
Iowa · 35190
Office
Unavailable
Facility
$607.09
No comparable office rate is available.
Idaho
Idaho · 35190
Office
Unavailable
Facility
$616.25
No comparable office rate is available.
East St. Louis
Illinois · 35190
Office
Unavailable
Facility
$788.17
No comparable office rate is available.
Rest Of Illinois
Illinois · 35190
Office
Unavailable
Facility
$736.89
No comparable office rate is available.
Suburban Chicago
Illinois · 35190
Office
Unavailable
Facility
$778.95
No comparable office rate is available.
Indiana
Indiana · 35190
Office
Unavailable
Facility
$618.67
No comparable office rate is available.
Kansas
Kansas · 35190
Office
Unavailable
Facility
$617.51
No comparable office rate is available.
Kentucky
Kentucky · 35190
Office
Unavailable
Facility
$661.30
No comparable office rate is available.
New Orleans
Louisiana · 35190
Office
Unavailable
Facility
$693.11
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 35190
Office
Unavailable
Facility
$665.54
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 35190
Office
Unavailable
Facility
$718.39
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 35190
Office
Unavailable
Facility
$677.69
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 35190
Office
Unavailable
Facility
$729.53
No comparable office rate is available.
Rest Of Maryland
Maryland · 35190
Office
Unavailable
Facility
$682.93
No comparable office rate is available.
Rest Of Maine
Maine · 35190
Office
Unavailable
Facility
$632.88
No comparable office rate is available.
Southern Maine
Maine · 35190
Office
Unavailable
Facility
$643.65
No comparable office rate is available.
Detroit
Michigan · 35190
Office
Unavailable
Facility
$757.77
No comparable office rate is available.
Rest Of Michigan
Michigan · 35190
Office
Unavailable
Facility
$688.47
No comparable office rate is available.
Minnesota
Minnesota · 35190
Office
Unavailable
Facility
$611.51
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 35190
Office
Unavailable
Facility
$675.09
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 35190
Office
Unavailable
Facility
$679.67
No comparable office rate is available.
Rest Of Missouri
Missouri · 35190
Office
Unavailable
Facility
$664.16
No comparable office rate is available.
Mississippi
Mississippi · 35190
Office
Unavailable
Facility
$637.81
No comparable office rate is available.
Montana**
Montana · 35190
Office
Unavailable
Facility
$685.83
No comparable office rate is available.
North Carolina
North Carolina · 35190
Office
Unavailable
Facility
$636.56
No comparable office rate is available.
North Dakota**
North Dakota · 35190
Office
Unavailable
Facility
$619.79
No comparable office rate is available.
Nebraska
Nebraska · 35190
Office
Unavailable
Facility
$606.07
No comparable office rate is available.
New Hampshire
New Hampshire · 35190
Office
Unavailable
Facility
$677.75
No comparable office rate is available.
Northern Nj
New Jersey · 35190
Office
Unavailable
Facility
$743.18
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 35190
Office
Unavailable
Facility
$727.01
No comparable office rate is available.
New Mexico
New Mexico · 35190
Office
Unavailable
Facility
$697.06
No comparable office rate is available.
Nevada**
Nevada · 35190
Office
Unavailable
Facility
$667.56
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 35190
Office
Unavailable
Facility
$835.63
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 35190
Office
Unavailable
Facility
$742.21
No comparable office rate is available.
Queens
New York · 35190
Office
Unavailable
Facility
$788.37
No comparable office rate is available.
Rest Of New York
New York · 35190
Office
Unavailable
Facility
$646.04
No comparable office rate is available.
Ohio
Ohio · 35190
Office
Unavailable
Facility
$674.97
No comparable office rate is available.
Oklahoma
Oklahoma · 35190
Office
Unavailable
Facility
$646.45
No comparable office rate is available.
Portland
Oregon · 35190
Office
Unavailable
Facility
$679.76
No comparable office rate is available.
Rest Of Oregon
Oregon · 35190
Office
Unavailable
Facility
$652.37
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 35190
Office
Unavailable
Facility
$721.09
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 35190
Office
Unavailable
Facility
$668.63
No comparable office rate is available.
Puerto Rico
Puerto Rico · 35190
Office
Unavailable
Facility
$685.89
No comparable office rate is available.
Rhode Island
Rhode Island · 35190
Office
Unavailable
Facility
$686.85
No comparable office rate is available.
South Carolina
South Carolina · 35190
Office
Unavailable
Facility
$658.86
No comparable office rate is available.
South Dakota**
South Dakota · 35190
Office
Unavailable
Facility
$611.98
No comparable office rate is available.
Tennessee
Tennessee · 35190
Office
Unavailable
Facility
$621.88
No comparable office rate is available.
Austin
Texas · 35190
Office
Unavailable
Facility
$682.19
No comparable office rate is available.
Beaumont
Texas · 35190
Office
Unavailable
Facility
$665.75
No comparable office rate is available.
Brazoria
Texas · 35190
Office
Unavailable
Facility
$663.77
No comparable office rate is available.
Dallas
Texas · 35190
Office
Unavailable
Facility
$673.59
No comparable office rate is available.
Fort Worth
Texas · 35190
Office
Unavailable
Facility
$673.67
No comparable office rate is available.
Galveston
Texas · 35190
Office
Unavailable
Facility
$669.40
No comparable office rate is available.
Houston
Texas · 35190
Office
Unavailable
Facility
$730.53
No comparable office rate is available.
Rest Of Texas
Texas · 35190
Office
Unavailable
Facility
$668.22
No comparable office rate is available.
Utah
Utah · 35190
Office
Unavailable
Facility
$666.42
No comparable office rate is available.
Virginia
Virginia · 35190
Office
Unavailable
Facility
$650.92
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 35190
Office
Unavailable
Facility
$685.89
No comparable office rate is available.
Vermont
Vermont · 35190
Office
Unavailable
Facility
$629.57
No comparable office rate is available.
Rest Of Washington
Washington · 35190
Office
Unavailable
Facility
$672.36
No comparable office rate is available.
Seattle (King Cnty)
Washington · 35190
Office
Unavailable
Facility
$718.72
No comparable office rate is available.
Wisconsin
Wisconsin · 35190
Office
Unavailable
Facility
$603.08
No comparable office rate is available.
West Virginia
West Virginia · 35190
Office
Unavailable
Facility
$716.11
No comparable office rate is available.
Wyoming**
Wyoming · 35190
Office
Unavailable
Facility
$657.05
No comparable office rate is available.
See how rates vary across the country
35190 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Where does this rate apply?
El Centro is a Medicare payment area. Our Census mapping connects it to 18 cities and communities in California, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 35190 in El Centro. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$721.04
$655.49 × 110% = $721.04
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 35190 in El Centro.
PPRRVU2026_Oct_nonQPP.csv
4,291
- Code
- 35190
- Physician work
- 13.08
- Practice expense
- 4.12
- Malpractice
- 3.34
GPCI2026.csv
10
- Locality
- El Centro
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.541
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 13.08 | × 1.017 | 13.3024 |
| Practice expense | 4.12 | × 1.096 | 4.5155 |
| Malpractice | 3.34 | × 0.541 | 1.8069 |
| Total RVUs | 19.6248 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, El Centro$655.49
Open 35190 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 13.08 | 1.017 |
| Practice expense | 4.12 | 1.096 |
| Malpractice | 3.34 | 0.541 |
(13.08 × 1.017 + 4.12 × 1.096 + 3.34 × 0.541) × $33.4009 = $655.49
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
35190 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $655.49 | RVU26D |
| 2026-07-01 | Not available in this setting | $655.49 | RVU26C |
| 2026-04-01 | Not available in this setting | $655.49 | RVU26B |
| 2026-01-01 | Not available in this setting | $655.49 | RVU26A |
| 2025-10-01 | Not available in this setting | $696.71 | RVU25D |
| 2025-07-01 | Not available in this setting | $696.71 | RVU25C |
| 2025-04-01 | Not available in this setting | $696.71 | RVU25B |
| 2025-01-01 | Not available in this setting | $696.71 | RVU25A |
35190 billing questions
How is this distinguished from 35184?
35190 is for repair of an acquired fistula in an extremity. 35184 is the corresponding code for a congenital extremity fistula.
Which documentation supports reporting 35190?
The operative report should identify the extremity site, the acquired fistula, the involved vessels, and the repair performed.
Can modifier 50 be used for bilateral repair?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate under that rule.
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-surgeons are paid only when supporting documentation is provided; team surgery is not permitted.
How does the multiple procedure rule affect payment?
When procedures are performed in the same session, the highest-valued procedure is paid in full and the other procedures are subject to the standard 50% 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
4,28835184,,Rpr cgen av fistula xtr,A,,18.35,3.30,NA,3.30,,4.69,26.34,26.34,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,28935188,,Rpr acq av fistula head&neck,A,,17.55,12.86,NA,12.86,,7.41,37.82,37.82,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,29035189,,Rpr acq av fistula thrx&abd,A,,29.23,4.40,NA,4.40,,7.46,41.09,41.09,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,29135190,,Repair acq av fistula xtr,A,,13.08,4.12,NA,4.12,,3.34,20.54,20.54,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,29235201,,Repair blood vessel dir neck,A,,16.51,4.79,NA,4.79,,4.02,25.32,25.32,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,29335206,,Repair blood vessel dir uxtr,A,,13.49,5.06,NA,5.06,,3.13,21.68,21.68,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,29435207,,Rpr bld vsl dir hand finger,A,,10.67,7.73,NA,7.73,,2.06,20.46,20.46,0,090,0.09,0.84,0.07,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
707102,AR,13,ARKANSAS,1.000,0.859,0.515
801112,CA,54,BAKERSFIELD,1.019,1.096,0.609
901112,CA,55,CHICO,1.017,1.096,0.536
1001182,CA,71,EL CENTRO,1.017,1.096,0.541
1101112,CA,56,FRESNO,1.017,1.096,0.536
1201112,CA,57,HANFORD-CORCORAN,1.017,1.096,0.536
1301182,CA,18,LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY),1.041,1.183,0.664