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CMS RVU26D · Effective 2026-10-01

35221 Vessel repair Medicare reimbursement rates in Iowa

Reports direct repair of an injured intra-abdominal blood vessel, such as primary suture closure, when the operative approach does not use a graft. Compare 35221 office and facility rates across CMS payment localities in Iowa.

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 35221 in Iowa?

Iowa 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

$1185.13

1 of 1 localities have a supported rate.

Payment area: Iowa

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.

Find 35221 in your payment locality →

Vascular surgery

About 35221: Direct intra-abdominal vessel repair

Reports direct repair of an injured intra-abdominal blood vessel, such as primary suture closure, when the operative approach does not use a graft.

This code describes direct repair of a blood vessel within the abdomen, typically by closing a defect in the vessel without inserting a graft. It may be performed by a vascular, trauma, or general surgeon when an abdominal vessel is injured, including during trauma care or another operation. The operative report should identify the vessel and its location and describe the direct repair performed.

Report this code when the documented work is a direct intra-abdominal vessel repair; a repair using a vein graft or another type of graft belongs to a different code. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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% reduction. For bilateral reporting with modifier 50, CMS pays at 150%. Assistant-at-surgery services may be paid; co-surgeons are paid only with supporting documentation, and team surgery is not permitted.

CMS billing rules for 35221

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 RVU25.95 · 65%
  • Practice expense (office) RVU7.58 · 19%
  • Malpractice RVU6.54 · 16%

1.5K

Medicare services in 2024 · #2670 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.

35221 compared with similar codes

Office rates for Iowa, from the same CMS release.

35251

Vessel repair

Intra-abdominal vein graft

No office rate

Both concern intra-abdominal vessels, but 35251 is for repair using a vein graft. Choose 35221 for direct repair without an interposed graft.

35281

Vessel repair

Nonvenous graft, intra-abdominal

No office rate

35281 covers intra-abdominal vessel repair using a graft other than a vein graft. This code is for direct repair.

35211

Vessel repair

Intrathoracic, with bypass

No office rate

35211 concerns direct repair of an intrathoracic vessel with bypass. This code is for an intra-abdominal vessel.

35216

Vessel repair

Intrathoracic, direct, no bypass

No office rate

35216 concerns direct repair of an intrathoracic vessel without bypass. Select this code when the repaired vessel is intra-abdominal.

Compare 35221 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

Office and facility base rates · shared scale starting at $0

  • Iowa →

    Office / nonfacility

    Unavailable

    Facility

    $1185.13

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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 35221 in Iowa.

PPRRVU2026_Oct_nonQPP.csv

4,298

Code
35221
Physician work
25.95
Practice expense
7.58
Malpractice
6.54

GPCI2026.csv

53

Locality
Iowa
Physician work
1.000
Practice expense
0.915
Malpractice
0.397
Facility calculation for 35221 in Iowa
ComponentRVULocality factorAdjusted
Physician work25.95× 1.00025.9500
Practice expense7.58× 0.9156.9357
Malpractice6.54× 0.3972.5964
Total RVUs35.4821
Conversion factor× 33.4009

Facility rate, Iowa$1185.13

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.
Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work25.951
Practice expense7.580.915
Malpractice6.540.397

(25.95 × 1 + 7.58 × 0.915 + 6.54 × 0.397) × $33.4009 = $1185.13

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.

35221 billing questions

How do I distinguish direct repair from a graft repair?

Use this code when the vessel is repaired directly, such as by closing the defect without an interposed graft. A vein graft or another graft material points to a different intra-abdominal repair code.

What documentation supports reporting this code?

The operative report should identify the intra-abdominal vessel and describe the direct repair technique. It should make clear whether a graft was used.

How does the multiple-procedure reduction affect this code?

When other procedures are performed in the same session, CMS pays the highest-valued procedure in full and applies the standard 50% reduction to the others.

Can modifier 50 be used for bilateral repair?

CMS lists this as a bilateral procedure; when reported bilaterally with modifier 50, payment is at 150%.

How are assistant and co-surgeon services handled?

Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation, while 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.

RVUs for 35221PPRRVU2026_Oct_nonQPP.csv, line 4,298 (RVU26D)
Geographic factors for IowaGPCI2026.csv, line 53 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet