No office rate
Choose 35103 for documented aortic rupture. Choose 35102 for an aortic arterial defect repair when rupture is not the indication.
On this page
CMS RVU26D · Effective 2026-10-01
35103 Aortic repair Medicare reimbursement rates in Hawaii
Open surgical repair of a ruptured aorta, reported when the operation addresses an actual aortic rupture rather than an arterial defect without rupture. Compare 35103 office and facility rates across CMS payment localities in Hawaii.
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 35103 in Hawaii?
Hawaii 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
$1838.12
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
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 35103: Aortic artery rupture repair
Open surgical repair of a ruptured aorta, reported when the operation addresses an actual aortic rupture rather than an arterial defect without rupture.
This code describes operative repair of a ruptured aorta, an emergency vascular procedure performed to control the rupture and restore aortic integrity. The rupture may occur in the setting of trauma or a ruptured aneurysm. A vascular or cardiothoracic surgeon typically performs the operation in a hospital operating room; these services are generally facility-based rather than office procedures.
Select the code when the operative report identifies an aortic rupture and documents its surgical repair. Distinguish it from repair of an aortic arterial defect without rupture and from rupture repairs at other anatomic sites. The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days. 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% reduction. CMS pays bilateral reporting with modifier 50 at 150%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 35103
- 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 RVU42.53 · 72%
- Practice expense (office) RVU5.45 · 9%
- Malpractice RVU10.89 · 18%
77
Medicare services in 2024 · #5086 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.
35103 compared with similar codes
Office rates for Hawaii, from the same CMS release.
No office rate
This code is for aortic rupture repair; 35112 identifies rupture repair at the spleen arterial site.
No office rate
This code identifies aortic rupture repair, while 35122 identifies rupture repair at an abdominal arterial site.
Compare 35103 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
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$1838.12
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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 35103 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
4,268
- Code
- 35103
- Physician work
- 42.53
- Practice expense
- 5.45
- Malpractice
- 10.89
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 42.53 | × 1.000 | 42.5300 |
| Practice expense | 5.45 | × 1.137 | 6.1966 |
| Malpractice | 10.89 | × 0.579 | 6.3053 |
| Total RVUs | 55.0320 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$1838.12
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 42.53 | 1 |
| Practice expense | 5.45 | 1.137 |
| Malpractice | 10.89 | 0.579 |
(42.53 × 1 + 5.45 × 1.137 + 10.89 × 0.579) × $33.4009 = $1838.12
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.
35103 billing questions
When should I choose 35103 instead of 35102?
Use 35103 when the operative documentation identifies a rupture of the aorta that is surgically repaired. Code 35102 is for an aortic arterial defect without the rupture distinction.
Does this code describe an endovascular procedure?
It describes surgical repair of a ruptured aorta. Do not use it to represent a separately performed endovascular repair.
What documentation supports reporting 35103?
The operative report should identify the aorta as the site, document the rupture, and describe the repair performed.
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.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction, with payment at 50%.
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.
4,26535091,,Repair defect of artery,A,,34.47,4.80,NA,4.80,,8.75,48.02,48.02,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,26635092,,Repair artery rupture aorta,A,,49.70,6.19,NA,6.19,,12.71,68.60,68.60,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,26735102,,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
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014