No office rate
Use 35111 for a splenic artery defect and 35112 when the operative documentation identifies a splenic artery rupture.
On this page
CMS RVU26D · Effective 2026-10-01
35111 Arterial repair Medicare reimbursement rates in California
Reports direct surgical repair of a splenic artery defect, with code selection based on the treated vessel and whether the condition is a defect or rupture. Compare 35111 office and facility rates across CMS payment localities in California.
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 35111 in California?
California has 29 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 29 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1134.34–$1260.26
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $125.92 per service.
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.
Where 35111 pays more and less in California
Vascular surgery
About 35111: Direct repair of splenic artery defect
Reports direct surgical repair of a splenic artery defect, with code selection based on the treated vessel and whether the condition is a defect or rupture.
CPT 35111 is used for direct repair of a defect in the splenic artery. Vascular or general surgeons may perform the repair during an operation for an arterial injury or another identified arterial defect. The operative report should identify the splenic artery, describe the defect and repair, and distinguish the condition from a rupture. The related code 35112 is specific to splenic artery rupture.
Report the code supported by the operative site and the condition treated; do not select it solely because an arterial repair occurred. This major surgery has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. 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 multiple procedure reduction. Modifier 50 is inappropriate for this code. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 35111
- 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 RVU25.62 · 71%
- Practice expense (office) RVU4.01 · 11%
- Malpractice RVU6.55 · 18%
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.
35111 compared with similar codes
Office rates for California, from the same CMS release.
No office rate
Both concern direct repair of an arterial defect, but code selection depends on the vessel and anatomic application documented in the operative report.
No office rate
This is another defect-repair code in the vascular series; distinguish it from 35111 by the applicable vessel and operative site.
Compare 35111 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.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield | Office Unavailable | Facility $1152.02 |
| Chico | Office Unavailable | Facility $1134.34 |
| El Centro | Office Unavailable | Facility $1135.43 |
| Fresno | Office Unavailable | Facility $1134.34 |
| Hanford-Corcoran | Office Unavailable | Facility $1134.34 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $1194.53 |
| Madera | Office Unavailable | Facility $1134.34 |
| Merced | Office Unavailable | Facility $1134.34 |
| Modesto | Office Unavailable | Facility $1134.34 |
| Napa | Office Unavailable | Facility $1197.31 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $1174.30 |
| Redding | Office Unavailable | Facility $1134.34 |
| Rest Of California | Office Unavailable | Facility $1134.34 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $1204.55 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $1159.57 |
| Salinas | Office Unavailable | Facility $1154.76 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $1160.17 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $1226.30 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $1218.86 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $1260.26 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $1229.85 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $1140.10 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $1153.70 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $1153.13 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $1163.14 |
| Stockton | Office Unavailable | Facility $1134.34 |
| Vallejo | Office Unavailable | Facility $1186.59 |
| Visalia | Office Unavailable | Facility $1134.34 |
| Yuba City | Office Unavailable | Facility $1134.34 |
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35111 billing questions
How is 35111 distinguished from 35112?
35111 is for direct repair of a splenic artery defect; 35112 is the related code for repair of a splenic artery rupture. The operative report should make the condition treated clear.
What documentation supports 35111?
Document the splenic artery as the vessel repaired, the defect treated, and the operative repair performed. The record should distinguish a defect from a rupture.
Can modifier 50 be reported?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
Is an assistant surgeon payable?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, and team surgery is not permitted under the stated CMS rules.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.
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.
4,26735102,,Repair defect of artery,A,,35.62,6.23,NA,6.23,,9.07,50.92,50.92,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,26835103,,Repair artery rupture aorta,A,,42.53,5.45,NA,5.45,,10.89,58.87,58.87,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,2693510F,,Doc tb scrng-rslts interpd,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
4,27035111,,Repair defect of artery,A,,25.62,4.01,NA,4.01,,6.55,36.18,36.18,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,27135112,,Repair artery rupture spleen,A,,31.76,4.60,NA,4.60,,8.12,44.48,44.48,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,2723511F,,Chlmyd/gonrh tsts docd 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
4,27335121,,Repair defect of artery,A,,30.73,4.42,NA,4.42,,7.87,43.02,43.02,0,090,0.09,0.84,0.07,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00