No office rate
Choose 35216 for direct intrathoracic repair without bypass; choose 35211 when bypass is used.
On this page
CMS RVU26D · Effective 2026-10-01
35216 in Merced
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$1835.61
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 35216: Direct intrathoracic vessel repair without bypass
Report this code for direct surgical repair of a blood vessel in the chest when the repair is performed without bypass.
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.
CMS billing rules for 35216
- 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 procedure with modifier 50 is paid at 150%.
- 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 RVU35.69 · 62%
- Practice expense (office) RVU12.82 · 22%
- Malpractice RVU8.60 · 15%
248
Medicare services in 2024 · #4145 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.
35216 compared with similar codes
Office rates for Merced, from the same CMS release.
No office rate
35216 describes direct repair without a graft, while 35246 is for intrathoracic repair using a vein graft without bypass.
No office rate
Both are direct repairs without bypass, but 35221 applies to an intra-abdominal vessel rather than an intrathoracic vessel.
The same code, a different location
How does Merced compare?
35216 across payment areas
Same release and payment basis · bars start at $0
Merced · 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.
Unavailable
No comparable rate is available in this setting.
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
Madera
California · 35216
Office
Unavailable
Facility
$1835.61
No comparable office rate is available.
Modesto
California · 35216
Office
Unavailable
Facility
$1835.61
No comparable office rate is available.
Napa
California · 35216
Office
Unavailable
Facility
$1977.47
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 35216
Office
Unavailable
Facility
$1910.54
No comparable office rate is available.
Redding
California · 35216
Office
Unavailable
Facility
$1835.61
No comparable office rate is available.
Rest Of California
California · 35216
Office
Unavailable
Facility
$1835.61
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 35216
Office
Unavailable
Facility
$1927.86
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 35216
Office
Unavailable
Facility
$1886.95
No comparable office rate is available.
Salinas
California · 35216
Office
Unavailable
Facility
$1879.28
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 35216
Office
Unavailable
Facility
$1895.66
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 35216
Office
Unavailable
Facility
$2040.93
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 35216
Office
Unavailable
Facility
$2031.17
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 35216
Office
Unavailable
Facility
$2094.64
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 35216
Office
Unavailable
Facility
$2054.71
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 35216
Office
Unavailable
Facility
$1854.03
No comparable office rate is available.
Santa Cruz-Watsonville
California · 35216
Office
Unavailable
Facility
$1891.34
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 35216
Office
Unavailable
Facility
$1878.70
No comparable office rate is available.
Santa Rosa-Petaluma
California · 35216
Office
Unavailable
Facility
$1907.63
No comparable office rate is available.
Stockton
California · 35216
Office
Unavailable
Facility
$1835.61
No comparable office rate is available.
Vallejo
California · 35216
Office
Unavailable
Facility
$1963.39
No comparable office rate is available.
Visalia
California · 35216
Office
Unavailable
Facility
$1835.61
No comparable office rate is available.
Yuba City
California · 35216
Office
Unavailable
Facility
$1835.61
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 35216
Office
Unavailable
Facility
$2080.58
No comparable office rate is available.
Miami
Florida · 35216
Office
Unavailable
Facility
$2364.28
No comparable office rate is available.
Chicago
Illinois · 35216
Office
Unavailable
Facility
$2290.00
No comparable office rate is available.
Manhattan
New York · 35216
Office
Unavailable
Facility
$2221.51
No comparable office rate is available.
Alaska*
Alaska · 35216
Office
Unavailable
Facility
$2402.42
No comparable office rate is available.
Alabama
Alabama · 35216
Office
Unavailable
Facility
$1729.33
No comparable office rate is available.
Arkansas
Arkansas · 35216
Office
Unavailable
Facility
$1707.83
No comparable office rate is available.
Arizona
Arizona · 35216
Office
Unavailable
Facility
$1852.89
No comparable office rate is available.
Colorado
Colorado · 35216
Office
Unavailable
Facility
$1886.33
No comparable office rate is available.
Connecticut
Connecticut · 35216
Office
Unavailable
Facility
$2024.66
No comparable office rate is available.
Delaware
Delaware · 35216
Office
Unavailable
Facility
$1879.34
No comparable office rate is available.
Fort Lauderdale
Florida · 35216
Office
Unavailable
Facility
$2145.19
No comparable office rate is available.
Rest Of Florida
Florida · 35216
Office
Unavailable
Facility
$2033.17
No comparable office rate is available.
Atlanta
Georgia · 35216
Office
Unavailable
Facility
$1975.69
No comparable office rate is available.
Rest Of Georgia
Georgia · 35216
Office
Unavailable
Facility
$1916.43
No comparable office rate is available.
Hawaii, Guam
Hawaii · 35216
Office
Unavailable
Facility
$1845.26
No comparable office rate is available.
Iowa
Iowa · 35216
Office
Unavailable
Facility
$1697.92
No comparable office rate is available.
Idaho
Idaho · 35216
Office
Unavailable
Facility
$1721.89
No comparable office rate is available.
East St. Louis
Illinois · 35216
Office
Unavailable
Facility
$2164.54
No comparable office rate is available.
Rest Of Illinois
Illinois · 35216
Office
Unavailable
Facility
$2031.99
No comparable office rate is available.
Suburban Chicago
Illinois · 35216
Office
Unavailable
Facility
$2149.19
No comparable office rate is available.
Indiana
Indiana · 35216
Office
Unavailable
Facility
$1728.62
No comparable office rate is available.
Kansas
Kansas · 35216
Office
Unavailable
Facility
$1723.94
No comparable office rate is available.
Kentucky
Kentucky · 35216
Office
Unavailable
Facility
$1835.58
No comparable office rate is available.
New Orleans
Louisiana · 35216
Office
Unavailable
Facility
$1921.33
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 35216
Office
Unavailable
Facility
$1846.22
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 35216
Office
Unavailable
Facility
$2007.87
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 35216
Office
Unavailable
Facility
$1890.98
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 35216
Office
Unavailable
Facility
$2025.93
No comparable office rate is available.
Rest Of Maryland
Maryland · 35216
Office
Unavailable
Facility
$1901.03
No comparable office rate is available.
Rest Of Maine
Maine · 35216
Office
Unavailable
Facility
$1764.69
No comparable office rate is available.
Southern Maine
Maine · 35216
Office
Unavailable
Facility
$1797.68
No comparable office rate is available.
Detroit
Michigan · 35216
Office
Unavailable
Facility
$2089.59
No comparable office rate is available.
Rest Of Michigan
Michigan · 35216
Office
Unavailable
Facility
$1907.33
No comparable office rate is available.
Minnesota
Minnesota · 35216
Office
Unavailable
Facility
$1717.72
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 35216
Office
Unavailable
Facility
$1874.80
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 35216
Office
Unavailable
Facility
$1887.55
No comparable office rate is available.
Rest Of Missouri
Missouri · 35216
Office
Unavailable
Facility
$1840.97
No comparable office rate is available.
Mississippi
Mississippi · 35216
Office
Unavailable
Facility
$1773.03
No comparable office rate is available.
Montana**
Montana · 35216
Office
Unavailable
Facility
$1906.95
No comparable office rate is available.
North Carolina
North Carolina · 35216
Office
Unavailable
Facility
$1775.14
No comparable office rate is available.
North Dakota**
North Dakota · 35216
Office
Unavailable
Facility
$1736.90
No comparable office rate is available.
Nebraska
Nebraska · 35216
Office
Unavailable
Facility
$1695.89
No comparable office rate is available.
New Hampshire
New Hampshire · 35216
Office
Unavailable
Facility
$1889.18
No comparable office rate is available.
Northern Nj
New Jersey · 35216
Office
Unavailable
Facility
$2070.67
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 35216
Office
Unavailable
Facility
$2022.47
No comparable office rate is available.
New Mexico
New Mexico · 35216
Office
Unavailable
Facility
$1929.72
No comparable office rate is available.
Nevada**
Nevada · 35216
Office
Unavailable
Facility
$1859.98
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 35216
Office
Unavailable
Facility
$2310.92
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 35216
Office
Unavailable
Facility
$2062.17
No comparable office rate is available.
Queens
New York · 35216
Office
Unavailable
Facility
$2188.71
No comparable office rate is available.
Rest Of New York
New York · 35216
Office
Unavailable
Facility
$1800.80
No comparable office rate is available.
Ohio
Ohio · 35216
Office
Unavailable
Facility
$1872.57
No comparable office rate is available.
Oklahoma
Oklahoma · 35216
Office
Unavailable
Facility
$1797.65
No comparable office rate is available.
Portland
Oregon · 35216
Office
Unavailable
Facility
$1900.59
No comparable office rate is available.
Rest Of Oregon
Oregon · 35216
Office
Unavailable
Facility
$1820.50
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 35216
Office
Unavailable
Facility
$2001.98
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 35216
Office
Unavailable
Facility
$1856.61
No comparable office rate is available.
Puerto Rico
Puerto Rico · 35216
Office
Unavailable
Facility
$1907.93
No comparable office rate is available.
Rhode Island
Rhode Island · 35216
Office
Unavailable
Facility
$1913.28
No comparable office rate is available.
South Carolina
South Carolina · 35216
Office
Unavailable
Facility
$1831.90
No comparable office rate is available.
South Dakota**
South Dakota · 35216
Office
Unavailable
Facility
$1716.79
No comparable office rate is available.
Tennessee
Tennessee · 35216
Office
Unavailable
Facility
$1735.56
No comparable office rate is available.
Austin
Texas · 35216
Office
Unavailable
Facility
$1902.00
No comparable office rate is available.
Beaumont
Texas · 35216
Office
Unavailable
Facility
$1848.59
No comparable office rate is available.
Brazoria
Texas · 35216
Office
Unavailable
Facility
$1850.01
No comparable office rate is available.
Dallas
Texas · 35216
Office
Unavailable
Facility
$1875.75
No comparable office rate is available.
Fort Worth
Texas · 35216
Office
Unavailable
Facility
$1875.20
No comparable office rate is available.
Galveston
Texas · 35216
Office
Unavailable
Facility
$1864.66
No comparable office rate is available.
Houston
Texas · 35216
Office
Unavailable
Facility
$2022.07
No comparable office rate is available.
Rest Of Texas
Texas · 35216
Office
Unavailable
Facility
$1857.82
No comparable office rate is available.
Utah
Utah · 35216
Office
Unavailable
Facility
$1852.53
No comparable office rate is available.
Virginia
Virginia · 35216
Office
Unavailable
Facility
$1815.80
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 35216
Office
Unavailable
Facility
$1907.93
No comparable office rate is available.
Vermont
Vermont · 35216
Office
Unavailable
Facility
$1761.34
No comparable office rate is available.
Rest Of Washington
Washington · 35216
Office
Unavailable
Facility
$1877.06
No comparable office rate is available.
Seattle (King Cnty)
Washington · 35216
Office
Unavailable
Facility
$2011.76
No comparable office rate is available.
Wisconsin
Wisconsin · 35216
Office
Unavailable
Facility
$1690.77
No comparable office rate is available.
West Virginia
West Virginia · 35216
Office
Unavailable
Facility
$1975.24
No comparable office rate is available.
Wyoming**
Wyoming · 35216
Office
Unavailable
Facility
$1832.84
No comparable office rate is available.
See how rates vary across the country
35216 · 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?
Merced is a Medicare payment area. Our Census mapping connects it to 24 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 35216 in Merced. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$2019.17
$1835.61 × 110% = $2019.17
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 35216 in Merced.
PPRRVU2026_Oct_nonQPP.csv
4,297
- Code
- 35216
- Physician work
- 35.69
- Practice expense
- 12.82
- Malpractice
- 8.60
GPCI2026.csv
15
- Locality
- Merced
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 35.69 | × 1.017 | 36.2967 |
| Practice expense | 12.82 | × 1.096 | 14.0507 |
| Malpractice | 8.60 | × 0.536 | 4.6096 |
| Total RVUs | 54.9570 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Merced$1835.61
Open 35216 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 35.69 | 1.017 |
| Practice expense | 12.82 | 1.096 |
| Malpractice | 8.6 | 0.536 |
(35.69 × 1.017 + 12.82 × 1.096 + 8.6 × 0.536) × $33.4009 = $1835.61
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
35216 · 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 | $1835.61 | RVU26D |
| 2026-07-01 | Not available in this setting | $1835.61 | RVU26C |
| 2026-04-01 | Not available in this setting | $1835.61 | RVU26B |
| 2026-01-01 | Not available in this setting | $1835.61 | RVU26A |
| 2025-10-01 | Not available in this setting | $1936.75 | RVU25D |
| 2025-07-01 | Not available in this setting | $1936.75 | RVU25C |
| 2025-04-01 | Not available in this setting | $1936.75 | RVU25B |
| 2025-01-01 | Not available in this setting | $1936.75 | RVU25A |
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 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.
4,29435207,,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
4,2953520F,,Cdifficile testing performed,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4,29635211,,Rpr blvsl dir ntrathrc w/byp,A,,23.97,9.63,NA,9.63,,5.93,39.53,39.53,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,29735216,,Rpr blvsl dir ntrthrc wo byp,A,,35.69,12.82,NA,12.82,,8.60,57.11,57.11,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,29835221,,Rpr bld vsl dir intra-abdl,A,,25.95,7.58,NA,7.58,,6.54,40.07,40.07,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,29935226,,Repair blood vessel dir lxtr,A,,14.92,3.98,NA,3.98,,3.75,22.65,22.65,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,30035231,,Repair blvsl vn grf neck,A,,20.63,8.07,NA,8.07,,3.79,32.49,32.49,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
1401112,CA,58,MADERA,1.017,1.096,0.536
1501112,CA,59,MERCED,1.017,1.096,0.536
1601112,CA,60,MODESTO,1.017,1.096,0.536
1701112,CA,51,NAPA,1.063,1.318,0.508
1801182,CA,17,OXNARD-THOUSAND OAKS-VENTURA,1.028,1.182,0.623