Billing code 35111: Arterial repairMedicare rate & RVUs in Massachusetts
Reports direct surgical repair of a splenic artery defect, with code selection based on the treated vessel and whether the condition is a defect or rupture.
CMS doesn’t publish an office rate for 35111 in Massachusetts.
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 35111 covers
billing code 35111 is used for direct repair of a defect in the splenic artery. Vascular or general surgeons may perform the repair during an operation for an arterial injury or another identified arterial defect. The operative report should identify the splenic artery, describe the defect and repair, and distinguish the condition from a rupture. The related code 35112 is specific to splenic artery rupture.
Report the code supported by the operative site and the condition treated; do not select it solely because an arterial repair occurred. This major surgery 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 the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate for this code. An assistant at surgery may be paid; co-surgeons require 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 35111 pays more and less in Massachusetts
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Boston | Unavailable | $1,245.45 |
| Rest Of Massachusetts | Unavailable | $1,184.82 |
How the 35111 rate is calculated
Each of 35111’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 · 35111
RVUs × geographic indexes × conversion factor
Work25.62
25.62 RVUs× 1.000 GPCI
Practice expense4.01
4.01 RVUs× 1.000 GPCI
Malpractice6.55
6.55 RVUs× 1.000 GPCI
Adjusted RVUs
36.1800
Conversion factor
$33.4009
Medicare rate
$1,208.44
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 35111
35111 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 35111
Arterial 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| 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 · 35111
Arterial 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 51 · payment effect
With and without the modifier
35111 without 51 · national facility
$1,208.44
Arterial repair
35111-51 · Second procedure: 50%
$604.22
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
35111 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 35112Artery repair
- Use 35111 for a splenic artery defect and 35112 when the operative documentation identifies a splenic artery rupture.
- 35102Aortic repair
- Both concern direct repair of an arterial defect, but code selection depends on the vessel and anatomic application documented in the operative report.
- 35121Arterial repair
- This is another defect-repair code in the vascular series; distinguish it from 35111 by the applicable vessel and operative site.
35111 billing questions
How is 35111 distinguished from 35112?
35111 is for direct repair of a splenic artery defect; 35112 is the related code for repair of a splenic artery rupture. The operative report should make the condition treated clear.
What documentation supports 35111?
Document the splenic artery as the vessel repaired, the defect treated, and the operative repair performed. The record should distinguish a defect from a rupture.
Can modifier 50 be reported?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
Is an assistant surgeon payable?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, and team surgery is not permitted under the stated CMS rules.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.
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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