No office rate
35121 describes direct repair of a visceral artery defect; 35122 is the corresponding code to consider when the documented condition is a visceral artery rupture.
On this page
CMS RVU26D · Effective 2026-10-01
35121 Arterial repair Medicare reimbursement rates in Hawaii
Open direct repair of a visceral artery defect is reported when the surgeon repairs the affected abdominal artery rather than treating a rupture. Compare 35121 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 35121 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
$1346.47
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 35121: Direct visceral artery defect repair
Open direct repair of a visceral artery defect is reported when the surgeon repairs the affected abdominal artery rather than treating a rupture.
This code represents open, direct repair of a defect in a visceral artery. A vascular or other qualified surgeon may perform the operation in a hospital operating room, for example to correct a localized arterial defect identified during treatment of an abdominal vascular condition. The operative report should identify the artery and defect, describe the repair performed, and distinguish a defect repair from treatment of a rupture or repair of a different named vessel.
Select the code based on the involved artery and the documented procedure; the rupture-specific visceral artery code is a nearby alternative when rupture is being repaired. This major surgery has a 90-day global period, including the day-before preoperative visit and related postoperative care during the following 90 days. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to standard multiple-procedure reduction. For bilateral procedures, modifier 50 is paid at 150%. Assistant-at-surgery payment may be allowed; co-surgeons and team surgery are not permitted.
CMS billing rules for 35121
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU30.73 · 71%
- Practice expense (office) RVU4.42 · 10%
- Malpractice RVU7.87 · 18%
68
Medicare services in 2024 · #5163 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.
35121 compared with similar codes
Office rates for Hawaii, from the same CMS release.
No office rate
35102 applies to direct repair involving the abdominal aorta. Use 35121 when the repaired vessel is a visceral artery rather than the aorta.
No office rate
35111 is a site-specific arterial repair code for a different vessel. Base selection on the artery identified in the operative report, not simply the abdominal location.
Compare 35121 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
$1346.47
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 35121 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
4,273
- Code
- 35121
- Physician work
- 30.73
- Practice expense
- 4.42
- Malpractice
- 7.87
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 30.73 | × 1.000 | 30.7300 |
| Practice expense | 4.42 | × 1.137 | 5.0255 |
| Malpractice | 7.87 | × 0.579 | 4.5567 |
| Total RVUs | 40.3123 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$1346.47
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 30.73 | 1 |
| Practice expense | 4.42 | 1.137 |
| Malpractice | 7.87 | 0.579 |
(30.73 × 1 + 4.42 × 1.137 + 7.87 × 0.579) × $33.4009 = $1346.47
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.
35121 billing questions
How is this code distinguished from 35122?
Use 35121 for direct repair of a visceral artery defect. The nearby 35122 code is for repair of a visceral artery rupture; the operative documentation should support the clinical circumstance.
What documentation supports reporting 35121?
Document the specific visceral artery, the defect being repaired, and the direct repair performed. The record should make clear whether the operation addressed a defect or a rupture.
Can an assistant-at-surgery be reported?
CMS identifies assistant-at-surgery payment as potentially payable for this procedure. Co-surgeons and team surgery are not permitted.
What is included in the global period?
The 90-day global 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 rule, the highest-valued procedure is paid in full and other procedures are subject to reduction when performed in the same session.
How is a bilateral procedure handled?
CMS identifies this as a bilateral procedure; modifier 50 is paid 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.
4,27035111,,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
4,27435122,,Repair artery rupture belly,A,,36.94,5.01,NA,5.01,,9.44,51.39,51.39,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,2753512F,,Syph scrng 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
4,27635131,,Repair defect of artery,A,,25.74,5.40,NA,5.40,,6.56,37.70,37.70,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,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