No office rate
35005 is for an intrathoracic arterial defect; 35001 is a related repair code for a different anatomical region.
On this page
CMS RVU26D · Effective 2026-10-01
35005 Artery repair Medicare reimbursement rates in Delaware
Reports surgical repair of an arterial defect within the chest, with code selection based on the vessel location and the operative service performed. Compare 35005 office and facility rates across CMS payment localities in Delaware.
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 35005 in Delaware?
Delaware 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
$894.34
1 of 1 localities have a supported rate.
Payment area: Delaware
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 35005: Intrathoracic arterial defect repair
Reports surgical repair of an arterial defect within the chest, with code selection based on the vessel location and the operative service performed.
CPT 35005 describes surgical repair of an arterial defect in the chest. A vascular or cardiothoracic surgeon may perform the repair in an operating room when an intrathoracic artery has a defect requiring operative correction. The operative report should identify the affected vessel and location, describe the defect, and document the repair performed. This code is distinct from arterial repairs assigned to other body regions and from codes describing rupture repairs.
Report the code when the documented service and arterial location meet its scope; the operative note should support the anatomical site and work. Medicare assigns a 90-day global period, including 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% multiple-procedure reduction. For bilateral reporting, modifier 50 is paid at 150%. Assistant-at-surgery payment may be allowed; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 35005
- 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 RVU18.81 · 69%
- Practice expense (office) RVU3.60 · 13%
- Malpractice RVU4.80 · 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.
35005 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
Choose 35005 for an intrathoracic defect rather than the arterial repair represented by 35011 for another body region.
No office rate
35005 describes repair of an arterial defect in the chest. 35022 is the related chest code when the documented circumstance is arterial rupture.
Compare 35005 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
Delaware →
Office / nonfacility
Unavailable
Facility
$894.34
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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 35005 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
4,254
- Code
- 35005
- Physician work
- 18.81
- Practice expense
- 3.60
- Malpractice
- 4.80
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 18.81 | × 1.005 | 18.9040 |
| Practice expense | 3.60 | × 0.988 | 3.5568 |
| Malpractice | 4.80 | × 0.899 | 4.3152 |
| Total RVUs | 26.7760 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$894.34
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 18.81 | 1.005 |
| Practice expense | 3.6 | 0.988 |
| Malpractice | 4.8 | 0.899 |
(18.81 × 1.005 + 3.6 × 0.988 + 4.8 × 0.899) × $33.4009 = $894.34
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.
35005 billing questions
How is 35005 distinguished from nearby arterial repair codes?
Use 35005 for an arterial defect in the chest. The operative documentation must support the intrathoracic location; neighboring codes may describe repairs in other regions or a rupture circumstance.
What documentation supports reporting 35005?
The operative report should identify the artery and its intrathoracic location, describe the defect, and document the surgical repair performed.
Does the 90-day global period include related postoperative care?
Yes. The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
How are multiple procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard 50% multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be allowed. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
How is bilateral reporting handled?
For a bilateral procedure reported with modifier 50, CMS applies the bilateral payment rule at 150%.
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.
4,2513498F,,Cd4+ cell >=15% (hiv),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
4,25235001,,Repair defect of artery,A,,20.29,4.72,NA,4.72,,5.13,30.14,30.14,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,25335002,,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
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503