No office rate
35206 is for direct repair of an upper-extremity vessel. Choose 35236 when reconstruction uses a vein graft.
On this page
CMS RVU26D · Effective 2026-10-01
35236 Vessel repair Medicare reimbursement rates in Hawaii
Reconstructs an upper-extremity blood vessel with a vein graft when a damaged segment or defect requires graft repair. Compare 35236 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 35236 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
$883.61
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 35236: Upper extremity vessel repair with vein graft
Reconstructs an upper-extremity blood vessel with a vein graft when a damaged segment or defect requires graft repair.
This service reconstructs a blood vessel in the arm or hand using a vein graft to restore blood flow across a damaged segment or defect. Vascular and other surgeons may perform it during operative treatment of an upper-extremity vessel injury or another condition requiring graft reconstruction, typically in a hospital or other surgical facility. The operative record should identify the vessel and site, the defect being repaired, and use of a vein graft.
Report this code when the repair is in the upper extremity and uses a vein graft; direct vessel repair and repair with a graft other than vein are distinct choices. The service 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 one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 for a bilateral procedure is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 35236
- 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 RVU17.57 · 64%
- Practice expense (office) RVU5.66 · 21%
- Malpractice RVU4.23 · 15%
275
Medicare services in 2024 · #4058 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.
35236 compared with similar codes
Office rates for Hawaii, from the same CMS release.
No office rate
Both involve graft repair of an upper-extremity vessel. The distinction is graft material: 35236 uses vein; 35266 uses another graft material.
No office rate
35256 describes vein-graft vessel repair in the lower extremity; 35236 is for the upper extremity.
No office rate
35231 describes vein-graft vessel repair in the neck. The operative site determines whether it or 35236 applies.
Compare 35236 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
$883.61
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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 35236 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
4,301
- Code
- 35236
- Physician work
- 17.57
- Practice expense
- 5.66
- Malpractice
- 4.23
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 17.57 | × 1.000 | 17.5700 |
| Practice expense | 5.66 | × 1.137 | 6.4354 |
| Malpractice | 4.23 | × 0.579 | 2.4492 |
| Total RVUs | 26.4546 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$883.61
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 17.57 | 1 |
| Practice expense | 5.66 | 1.137 |
| Malpractice | 4.23 | 0.579 |
(17.57 × 1 + 5.66 × 1.137 + 4.23 × 0.579) × $33.4009 = $883.61
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.
35236 billing questions
When is 35236 reported instead of 35206?
Use 35236 when the upper-extremity vessel repair uses a vein graft. Code 35206 describes direct repair without a graft.
How does 35236 differ from 35266?
Both describe graft repair in the upper extremity, but 35236 is for a vein graft and 35266 is for a graft other than vein.
What documentation supports reporting 35236?
Document the upper-extremity vessel and site, the defect or injury, and that a vein graft was used to reconstruct the vessel.
How is bilateral reporting handled?
For a bilateral procedure, modifier 50 is paid at 150% under the CMS rule supplied for this code.
What should the billing team know about surgical assistance and the global period?
Assistant-at-surgery payment may be available, while co-surgeon payment requires supporting documentation. The 90-day global includes the day-before preoperative visit and related postoperative care.
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.
4,29835221,,Rpr bld vsl dir intra-abdl,A,,25.95,7.58,NA,7.58,,6.54,40.07,40.07,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,29935226,,Repair blood vessel dir lxtr,A,,14.92,3.98,NA,3.98,,3.75,22.65,22.65,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,30035231,,Repair blvsl vn grf neck,A,,20.63,8.07,NA,8.07,,3.79,32.49,32.49,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,30135236,,Repair blvsl vn grf uxtr,A,,17.57,5.66,NA,5.66,,4.23,27.46,27.46,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,30235241,,Rpr blvsl vn grf ntrthrc w/b,A,,24.94,10.10,NA,10.10,,5.98,41.02,41.02,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,30335246,,Rpr blvsl vn grf ntrthrc w/o,A,,27.52,10.32,NA,10.32,,6.59,44.43,44.43,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,30435251,,Rpr blvsl vn grf intra-abdl,A,,31.11,7.91,NA,7.91,,7.85,46.87,46.87,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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