No office rate
Both describe direct vessel repair, but 35207 is for the hand or fingers; 35206 is for other upper-extremity sites.
On this page
CMS RVU26D · Effective 2026-10-01
35206 Vessel repair Medicare reimbursement rates in Illinois
Reports direct operative repair of an injured blood vessel in the upper extremity when the vessel can be repaired without a graft. Compare 35206 office and facility rates across CMS payment localities in Illinois.
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 35206 in Illinois?
Illinois has 4 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 4 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$768.29–$863.52
4 of 4 localities have a supported rate.
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.
Where 35206 pays more and less in Illinois
Vascular surgery
About 35206: Direct upper-extremity vessel repair
Reports direct operative repair of an injured blood vessel in the upper extremity when the vessel can be repaired without a graft.
A vascular, trauma, or other qualified surgeon reports this service for direct repair of an upper-extremity blood vessel, such as a primary repair of a lacerated artery or vein or a direct end-to-end repair. The code is selected for the upper extremity; repairs in the hand or fingers and repairs in other body regions have separate site-specific codes. The repair is performed in an operative setting, commonly after traumatic vessel injury or during surgery when an injured vessel requires reconstruction.
Documentation should identify the vessel and upper-extremity site, the injury or defect, and the direct repair performed without a graft. This major surgery has a 90-day global period, including the day-before preoperative visit and related postoperative care for 90 days. 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% multiple-procedure reduction. Modifier 50 bilateral reporting 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 35206
- 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 RVU13.49 · 62%
- Practice expense (office) RVU5.06 · 23%
- Malpractice RVU3.13 · 14%
1.4K
Medicare services in 2024 · #2741 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.
35206 compared with similar codes
Office rates for Illinois, from the same CMS release.
No office rate
This is the direct-repair code for the lower extremity. Choose 35206 when the repaired vessel is in the upper extremity.
No office rate
35236 describes upper-extremity repair using a vein graft. Use 35206 when the vessel is repaired directly without a graft.
No office rate
35266 describes upper-extremity repair using a graft other than a vein; 35206 is for direct repair without a graft.
Compare 35206 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.
4 of 4 payment localities
Chicago →
Office / nonfacility
Unavailable
Facility
$863.52
East St. Louis →
Office / nonfacility
Unavailable
Facility
$816.62
Rest Of Illinois →
Office / nonfacility
Unavailable
Facility
$768.29
Suburban Chicago →
Office / nonfacility
Unavailable
Facility
$812.56
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35206 billing questions
How does this differ from the hand and finger repair code?
Use 35206 for direct vessel repair in the upper extremity outside the hand and fingers. Code 35207 identifies direct repair at the hand or finger site.
When is a graft code more appropriate?
This code describes direct repair without a graft. When the reconstruction uses a vein graft or a graft other than a vein, consider the corresponding upper-extremity graft code instead.
What documentation supports reporting 35206?
The operative report should establish the upper-extremity vessel and site, the injury or defect, and how the surgeon repaired it directly without a graft.
How are bilateral repairs and multiple procedures handled?
CMS pays bilateral reporting with modifier 50 at 150%. For multiple procedures in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction.
What should the practice know about surgical assistance and the global period?
Assistant-at-surgery payment may be allowed, while co-surgeon payment requires supporting documentation; team surgery is not permitted. 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.
4,29035189,,Rpr acq av fistula thrx&abd,A,,29.23,4.40,NA,4.40,,7.46,41.09,41.09,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,29135190,,Repair acq av fistula xtr,A,,13.08,4.12,NA,4.12,,3.34,20.54,20.54,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,29235201,,Repair blood vessel dir neck,A,,16.51,4.79,NA,4.79,,4.02,25.32,25.32,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,29335206,,Repair blood vessel dir uxtr,A,,13.49,5.06,NA,5.06,,3.13,21.68,21.68,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,29435207,,Rpr bld vsl dir hand finger,A,,10.67,7.73,NA,7.73,,2.06,20.46,20.46,0,090,0.09,0.84,0.07,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,2953520F,,Cdifficile testing performed,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
4,29635211,,Rpr blvsl dir ntrathrc w/byp,A,,23.97,9.63,NA,9.63,,5.93,39.53,39.53,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00