Billing code 35236: Vessel repairMedicare rate & RVUs in Illinois
Reconstructs an upper-extremity blood vessel with a vein graft when a damaged segment or defect requires graft repair.
CMS doesn’t publish an office rate for 35236 in Illinois.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 35236 covers
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.
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.
Where 35236 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $1,105.21 |
| East St. Louis | Unavailable | $1,045.33 |
| Rest Of Illinois | Unavailable | $980.29 |
| Suburban Chicago | Unavailable | $1,035.47 |
How the 35236 rate is calculated
Each of 35236’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 35236
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 17.57Practice expense 5.66Malpractice 4.23
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 35236
35236 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 35236
Vessel repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.84/0.07 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 35236
Vessel repair
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
35236 without 50 · national facility
$917.19
Vessel repair
35236-50 · Bilateral: 150%
$1,375.79
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
35236 compared with similar codes
Compare codes
35236 vs 35206 vs 35266 vs 35256 vs 35231: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 35206Vessel repair
- 35206 is for direct repair of an upper-extremity vessel. Choose 35236 when reconstruction uses a vein graft.
- 35266Vessel repair
- Both involve graft repair of an upper-extremity vessel. The distinction is graft material: 35236 uses vein; 35266 uses another graft material.
- 35256Vessel repair
- 35256 describes vein-graft vessel repair in the lower extremity; 35236 is for the upper extremity.
- 35231Vascular repair
- 35231 describes vein-graft vessel repair in the neck. The operative site determines whether it or 35236 applies.
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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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