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CMS RVU26D · Effective 2026-10-01

35091 Artery repair Medicare reimbursement rates in Colorado

Report this code for direct surgical repair of a defect in an intrathoracic artery other than the aorta, with or without a patch graft. Compare 35091 office and facility rates across CMS payment localities in Colorado.

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 35091 in Colorado?

Colorado 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

$1563.98

1 of 1 localities have a supported rate.

Payment area: Colorado

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.

Find 35091 in your payment locality →

Vascular surgery

About 35091: Intrathoracic artery defect repair

Report this code for direct surgical repair of a defect in an intrathoracic artery other than the aorta, with or without a patch graft.

This code describes surgical repair of a defect in an artery within the chest, excluding the aorta. The surgeon closes the arterial defect directly, with a patch graft when needed. It may be used for repair of an injured or otherwise defective intrathoracic artery during an open operation. The operative report should identify the vessel and its location, the defect being repaired, and the repair performed.

Report the code for the intrathoracic arterial repair, not for repair of the aorta; aortic repair is represented by a different code. Documentation should distinguish the vessel from nearby structures and support the operative work. The service has a 90-day global period, which includes the day-before preoperative visit and related postoperative care through day 90. 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. Bilateral reporting with modifier 50 is 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 35091

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 RVU34.47 · 72%
  • Practice expense (office) RVU4.80 · 10%
  • Malpractice RVU8.75 · 18%

279

Medicare services in 2024 · #4049 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.

35091 compared with similar codes

Office rates for Colorado, from the same CMS release.

35092

Aortic rupture repair

Thoracoabdominal aorta

No office rate

Choose 35091 for an intrathoracic artery other than the aorta. Choose 35092 when the repaired vessel is the thoracic aorta.

35081

Aortic aneurysm repair

Visceral vessels, direct repair

No office rate

35081 concerns an intra-abdominal artery other than the aorta; 35091 concerns an intrathoracic artery other than the aorta.

35082

Aortic rupture repair

Abdominal aorta, open repair

No office rate

35082 is for abdominal aortic repair. The vessel coded with 35091 is in the chest and is not the aorta.

Compare 35091 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

Office and facility base rates · shared scale starting at $0

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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 35091 in Colorado.

PPRRVU2026_Oct_nonQPP.csv

4,265

Code
35091
Physician work
34.47
Practice expense
4.80
Malpractice
8.75

GPCI2026.csv

37

Locality
Colorado
Physician work
1.012
Practice expense
1.064
Malpractice
0.781
Facility calculation for 35091 in Colorado
ComponentRVULocality factorAdjusted
Physician work34.47× 1.01234.8836
Practice expense4.80× 1.0645.1072
Malpractice8.75× 0.7816.8338
Total RVUs46.8246
Conversion factor× 33.4009

Facility rate, Colorado$1563.98

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.
Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work34.471.012
Practice expense4.81.064
Malpractice8.750.781

(34.47 × 1.012 + 4.8 × 1.064 + 8.75 × 0.781) × $33.4009 = $1563.98

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.

35091 billing questions

How is this code distinguished from 35092?

This code is for a non-aortic artery in the chest. Use 35092 for repair of the thoracic aorta.

Can a patch graft be part of the repair?

Yes. The repair may include a patch graft; the operative report should describe the defect and the technique used.

What documentation supports reporting this code?

Document the specific intrathoracic artery, the defect repaired, and the direct repair performed, including any patch graft.

How does the 90-day global period affect postoperative reporting?

The day-before preoperative visit and related postoperative care through 90 days are included in the global period.

Can an assistant surgeon or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

How is bilateral performance handled?

When the qualifying procedure is performed bilaterally, modifier 50 is paid at 150% under the CMS rule for this code.

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.

RVUs for 35091PPRRVU2026_Oct_nonQPP.csv, line 4,265 (RVU26D)
Geographic factors for ColoradoGPCI2026.csv, line 37 (RVU26D)