No office rate
35013 is the related upper-extremity repair code for a rupture; 35011 is selected for direct repair of an arterial defect.
On this page
CMS RVU26D · Effective 2026-10-01
35011 Artery repair Medicare reimbursement rates in Alabama
Direct repair of an upper-extremity artery defect is reported when the surgeon closes a localized arterial wall injury without replacing the vessel segment. Compare 35011 office and facility rates across CMS payment localities in Alabama.
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.
What does Medicare pay for 35011 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$827.16
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Vascular surgery
About 35011: Direct upper-extremity artery repair
Direct repair of an upper-extremity artery defect is reported when the surgeon closes a localized arterial wall injury without replacing the vessel segment.
Code 35011 represents direct operative closure of a defect in an artery of the upper extremity. Vascular surgeons typically perform this repair in an operating room for a localized arterial wall injury or defect, including an injury encountered during another operation. The operative report should identify the artery and describe the defect and repair. A repair for rupture is a different circumstance represented by 35013.
Select the code based on the artery’s location and the repair performed. Documentation should support the upper-extremity site and direct repair of the defect. This major surgery code includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral reporting with modifier 50, CMS pays 150%. Assistant-at-surgery payment may be made; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 35011
- 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 RVU18.12 · 66%
- Practice expense (office) RVU4.56 · 17%
- Malpractice RVU4.69 · 17%
879
Medicare services in 2024 · #3063 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.
35011 compared with similar codes
Office rates for Alabama, from the same CMS release.
No office rate
35002 describes an arterial rupture repair in the neck, rather than an upper-extremity arterial defect.
No office rate
35022 describes an arterial rupture repair in the chest; 35011 is for an upper-extremity arterial defect.
Compare 35011 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alabama →
Office / nonfacility
Unavailable
Facility
$827.16
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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 35011 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
4,256
- Code
- 35011
- Physician work
- 18.12
- Practice expense
- 4.56
- Malpractice
- 4.69
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 18.12 | × 1.000 | 18.1200 |
| Practice expense | 4.56 | × 0.875 | 3.9900 |
| Malpractice | 4.69 | × 0.566 | 2.6545 |
| Total RVUs | 24.7645 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Alabama$827.16
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 18.12 | 1 |
| Practice expense | 4.56 | 0.875 |
| Malpractice | 4.69 | 0.566 |
(18.12 × 1 + 4.56 × 0.875 + 4.69 × 0.566) × $33.4009 = $827.16
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.
35011 billing questions
When should 35013 be considered instead?
Use 35013 when the upper-extremity arterial repair is for rupture. Code 35011 describes direct repair of an arterial defect in that region.
What documentation supports 35011?
Document the artery and upper-extremity location, the defect being repaired, and the direct repair performed. The operative report should make the reason for choosing this repair clear.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
How is bilateral repair reported?
When the qualifying procedure is performed bilaterally, 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-surgeons require 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 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.
4,25335002,,Repair artery rupture neck,A,,21.67,3.83,NA,3.83,,5.54,31.04,31.04,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,25435005,,Repair defect of artery,A,,18.81,3.60,NA,3.60,,4.80,27.21,27.21,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,2553500F,,Cd4+cell cnt/% docd as done,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
4,25635011,,Repair defect of artery,A,,18.12,4.56,NA,4.56,,4.69,27.37,27.37,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,25735013,,Repair artery rupture arm,A,,22.65,3.88,NA,3.88,,5.78,32.31,32.31,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,25835021,,Repair defect of artery,A,,21.62,9.42,NA,9.42,,5.16,36.20,36.20,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,25935022,,Repair artery rupture chest,A,,25.06,10.12,NA,10.12,,6.01,41.19,41.19,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515