No office rate
35201 describes direct neck-vessel repair without a graft. Choose 35261 when the neck vessel is reconstructed using a graft other than a vein.
On this page
CMS RVU26D · Effective 2026-10-01
35261 Vessel repair Medicare reimbursement rates in Kentucky
Reports open reconstruction of a neck blood vessel using a graft other than a vein, such as when vessel damage requires graft repair. Compare 35261 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 35261 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
$870.52
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 35261: Neck vessel repair with non-vein graft
Reports open reconstruction of a neck blood vessel using a graft other than a vein, such as when vessel damage requires graft repair.
A surgeon uses this service to reconstruct a blood vessel in the neck with a graft made from material other than a vein. A carotid artery repair using a non-vein graft is a representative situation. The work is typically performed in an operating room by a vascular surgeon or another surgeon managing a neck vascular injury or defect. The operative report should identify the vessel, the neck location, and the graft used.
Choose this code when the neck vessel repair requires a non-vein graft, rather than direct vessel repair or a vein graft. The documentation should support the graft-based reconstruction and distinguish it from other repairs performed during the same session. 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 one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 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 35261
- 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 RVU18.49 · 69%
- Practice expense (office) RVU3.65 · 14%
- Malpractice RVU4.73 · 18%
76
Medicare services in 2024 · #5094 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.
35261 compared with similar codes
Office rates for Kentucky, from the same CMS release.
No office rate
Both involve graft repair of a neck vessel, but 35231 specifies a vein graft. Use 35261 for a graft other than a vein.
No office rate
35266 is the corresponding non-vein graft repair for a vessel in the upper extremity. The repaired vessel's location determines whether 35261 or 35266 applies.
Compare 35261 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
$870.52
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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 35261 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
4,306
- Code
- 35261
- Physician work
- 18.49
- Practice expense
- 3.65
- Malpractice
- 4.73
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 18.49 | × 1.000 | 18.4900 |
| Practice expense | 3.65 | × 0.889 | 3.2449 |
| Malpractice | 4.73 | × 0.915 | 4.3280 |
| Total RVUs | 26.0628 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kentucky$870.52
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 18.49 | 1 |
| Practice expense | 3.65 | 0.889 |
| Malpractice | 4.73 | 0.915 |
(18.49 × 1 + 3.65 × 0.889 + 4.73 × 0.915) × $33.4009 = $870.52
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.
35261 billing questions
How does this differ from 35231?
Both codes describe graft repair of a neck blood vessel. Use 35261 for a graft other than a vein; 35231 is for a vein graft.
When is 35201 a better fit?
Use 35201 for direct repair of a neck blood vessel without graft reconstruction. Use 35261 when the documented repair uses a non-vein graft.
What should the operative report document?
Document the neck vessel repaired, the need for graft reconstruction, and that the graft material was other than a vein. The report should also distinguish the repair from any separate procedures performed in the same session.
How does the 90-day global period affect follow-up billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period. Unrelated services require documentation supporting their separate nature.
How are multiple procedures and bilateral repairs handled?
For multiple procedures in the same session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. CMS pays bilateral reporting with modifier 50 at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be allowed. Co-surgeon payment requires supporting documentation; 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.
4,30335246,,Rpr blvsl vn grf ntrthrc w/o,A,,27.52,10.32,NA,10.32,,6.59,44.43,44.43,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,30435251,,Rpr blvsl vn grf intra-abdl,A,,31.11,7.91,NA,7.91,,7.85,46.87,46.87,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,30535256,,Repair blvsl vn grf lxtr,A,,18.58,4.67,NA,4.67,,4.52,27.77,27.77,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,30635261,,Rpr blvsl grf oth/thn vn nck,A,,18.49,3.65,NA,3.65,,4.73,26.87,26.87,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,30735266,,Rpr blvsl grf oth/th vn uxtr,A,,15.43,4.24,NA,4.24,,3.92,23.59,23.59,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,30835271,,Rpr blvs gr ot/th vn ntrth w,A,,23.97,9.89,NA,9.89,,5.73,39.59,39.59,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,30935276,,Rpr blvs gr ot/t vn ntrth wo,A,,25.18,10.54,NA,10.54,,6.03,41.75,41.75,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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