No office rate
Both concern the thorax or abdomen, but 35182 is for congenital origin and 35189 is for acquired origin.
On this page
CMS RVU26D · Effective 2026-10-01
35182 AV fistula repair Medicare reimbursement rates in Kentucky
Reports open surgical correction of a congenital artery-to-vein connection located in the thorax or abdomen, with repair tailored to the involved anatomy. Compare 35182 office and facility rates across CMS payment localities in Kentucky.
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 35182 in Kentucky?
Kentucky 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
$1622.39
1 of 1 localities have a supported rate.
Payment area: Kentucky
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 35182: Congenital thoracoabdominal AV fistula repair
Reports open surgical correction of a congenital artery-to-vein connection located in the thorax or abdomen, with repair tailored to the involved anatomy.
This service is the operative correction of an abnormal artery-to-vein connection that is congenital and located in the thoracic or abdominal region. A vascular surgeon or another surgeon with relevant vascular expertise performs the repair, typically in a hospital operating room. The operative approach and any vessel reconstruction depend on the fistula’s anatomy and the structures involved. This code is distinct from repair of an acquired fistula and from congenital fistula repair in the head, neck, or extremities.
Select the code when the record establishes both congenital origin and a thoracic or abdominal site. The operative report should identify the location and document the repair performed. This major operation has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 35182
- 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- 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 RVU30.92 · 61%
- Practice expense (office) RVU11.85 · 23%
- Malpractice RVU7.78 · 15%
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.
35182 compared with similar codes
Office rates for Kentucky, from the same CMS release.
No office rate
This code is for congenital fistula repair in the thorax or abdomen; 35180 is for the head or neck.
No office rate
This code is for congenital fistula repair in the thorax or abdomen; 35184 is for an extremity.
Compare 35182 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
Kentucky →
Office / nonfacility
Unavailable
Facility
$1622.39
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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 35182 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
4,287
- Code
- 35182
- Physician work
- 30.92
- Practice expense
- 11.85
- Malpractice
- 7.78
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 30.92 | × 1.000 | 30.9200 |
| Practice expense | 11.85 | × 0.889 | 10.5346 |
| Malpractice | 7.78 | × 0.915 | 7.1187 |
| Total RVUs | 48.5734 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kentucky$1622.39
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 30.92 | 1 |
| Practice expense | 11.85 | 0.889 |
| Malpractice | 7.78 | 0.915 |
(30.92 × 1 + 11.85 × 0.889 + 7.78 × 0.915) × $33.4009 = $1622.39
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.
35182 billing questions
How do I distinguish this code from 35189?
Use 35182 for a congenital fistula in the thorax or abdomen. Code 35189 is for an acquired fistula in those regions.
What documentation supports reporting this code?
The operative record should establish congenital origin, identify the thoracic or abdominal location, and describe the repair performed.
Are related postoperative visits separately included?
Related postoperative care during the 90-day global period is included, along with the day-before preoperative visit.
Can modifier 50 be reported for bilateral repair?
No. CMS identifies bilateral adjustment as inappropriate for this code.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation.
How is this code paid when another procedure is performed in the same session?
The highest-valued procedure is paid in full; other procedures in the same session are subject to the standard multiple procedure reduction.
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.
4,2843515F,,Pt has docd immun to hep c,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
4,2853517F,,Hbv assess&results intrp 1yr,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
4,28635180,,Rpr cgen av fistula head&nck,A,,14.72,3.00,NA,3.00,,3.75,21.47,21.47,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,28735182,,Rpr cgen av fistula thrx&abd,A,,30.92,11.85,NA,11.85,,7.78,50.55,50.55,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,28835184,,Rpr cgen av fistula xtr,A,,18.35,3.30,NA,3.30,,4.69,26.34,26.34,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,28935188,,Rpr acq av fistula head&neck,A,,17.55,12.86,NA,12.86,,7.41,37.82,37.82,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,29035189,,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
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
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631