No office rate
Choose 35216 for direct intrathoracic repair without bypass; choose 35211 when bypass is used.
On this page
CMS RVU26D · Effective 2026-10-01
35216 Vessel repair Medicare reimbursement rates in Indiana
Report this code for direct surgical repair of a blood vessel in the chest when the repair is performed without bypass. Compare 35216 office and facility rates across CMS payment localities in Indiana.
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 35216 in Indiana?
Indiana 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
$1728.62
1 of 1 localities have a supported rate.
Payment area: Indiana
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 35216: Direct intrathoracic vessel repair without bypass
Report this code for direct surgical repair of a blood vessel in the chest when the repair is performed without bypass.
This service covers direct operative repair of an intrathoracic blood vessel, such as repair of a vessel injured during chest trauma or another thoracic operation. A cardiothoracic or vascular surgeon typically performs it in an operating room as part of a major procedure. The repair addresses the vessel itself without a bypass; it is distinct from repair using a vein graft or another graft method.
Select the code based on the operative site, direct repair method, and whether bypass was used. The operative report should identify the vessel and chest location and describe the repair and any bypass or graft. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures at 50%. Modifier 50 identifies bilateral performance, paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 35216
- 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 RVU35.69 · 62%
- Practice expense (office) RVU12.82 · 22%
- Malpractice RVU8.60 · 15%
248
Medicare services in 2024 · #4145 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.
35216 compared with similar codes
Office rates for Indiana, from the same CMS release.
No office rate
35216 describes direct repair without a graft, while 35246 is for intrathoracic repair using a vein graft without bypass.
No office rate
Both are direct repairs without bypass, but 35221 applies to an intra-abdominal vessel rather than an intrathoracic vessel.
Compare 35216 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
Indiana →
Office / nonfacility
Unavailable
Facility
$1728.62
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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 35216 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
4,297
- Code
- 35216
- Physician work
- 35.69
- Practice expense
- 12.82
- Malpractice
- 8.60
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 35.69 | × 1.000 | 35.6900 |
| Practice expense | 12.82 | × 0.927 | 11.8841 |
| Malpractice | 8.60 | × 0.486 | 4.1796 |
| Total RVUs | 51.7537 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Indiana$1728.62
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 35.69 | 1 |
| Practice expense | 12.82 | 0.927 |
| Malpractice | 8.6 | 0.486 |
(35.69 × 1 + 12.82 × 0.927 + 8.6 × 0.486) × $33.4009 = $1728.62
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.
35216 billing questions
How is 35216 different from 35211?
Both describe direct intrathoracic vessel repair, but 35216 is for repair without bypass. Use 35211 when the repair includes bypass.
When should a vein-graft repair be considered instead?
If the surgeon repairs the intrathoracic vessel using a vein graft, compare 35246 rather than reporting the direct-repair code.
What documentation supports 35216?
The operative report should identify the vessel and intrathoracic site and describe the direct repair, including whether bypass or a graft was used.
How does CMS handle bilateral reporting?
For bilateral performance, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
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.
4,29435207,,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
4,29735216,,Rpr blvsl dir ntrthrc wo byp,A,,35.69,12.82,NA,12.82,,8.60,57.11,57.11,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,29835221,,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
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915