No office rate
Both address an extremity arteriovenous fistula; choose 35184 for a congenital fistula and 35190 for an acquired fistula.
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CMS RVU26D · Effective 2026-10-01
35184 Fistula repair Medicare reimbursement rates in Michigan
Surgical repair of a congenital artery-to-vein connection in an arm or leg, reported when operative treatment addresses an extremity fistula. Compare 35184 office and facility rates across CMS payment localities in Michigan.
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 35184 in Michigan?
Michigan has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$890.40–$983.38
2 of 2 localities have a supported rate.
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 35184: Congenital extremity arteriovenous fistula repair
Surgical repair of a congenital artery-to-vein connection in an arm or leg, reported when operative treatment addresses an extremity fistula.
This operation closes or reconstructs an abnormal artery-to-vein connection that has been present from birth in an arm or leg. A vascular surgeon typically performs it in an operating room, often for a congenital lesion causing high-flow shunting, limb enlargement, pain, or other effects of altered circulation. The operative report should establish the congenital fistula and identify the extremity treated; acquired fistulas and congenital fistulas in other body regions are coded differently.
Select this code based on both the congenital origin and extremity location, and document the operative work performed to repair the fistula. Medicare assigns 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% multiple-procedure reduction. Bilateral adjustment does not apply, so modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 35184
- 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 RVU18.35 · 70%
- Practice expense (office) RVU3.30 · 13%
- Malpractice RVU4.69 · 18%
15
Medicare services in 2024 · #6069 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.
35184 compared with similar codes
Office rates for Michigan, from the same CMS release.
No office rate
This is the congenital fistula repair code for the head and neck; 35184 is for an extremity.
No office rate
This is the congenital fistula repair code for the thorax or abdomen; 35184 is for an extremity.
Compare 35184 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.
2 of 2 payment localities
Detroit →
Office / nonfacility
Unavailable
Facility
$983.38
Rest Of Michigan →
Office / nonfacility
Unavailable
Facility
$890.40
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35184 billing questions
How is this code distinguished from repair of an acquired fistula?
Use this code when the operative documentation identifies the extremity fistula as congenital. For an acquired extremity fistula, consider 35190.
Which congenital fistula repairs belong in this code?
The fistula must be in an extremity. Congenital repairs in the head or neck and in the thorax or abdomen have separate codes, 35180 and 35182.
Can modifier 50 be appended for repair of both extremities?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used.
Is related postoperative care billed separately?
Related postoperative care during the 90-day global period is included, along with the preoperative visit on the day before surgery.
How are other procedures performed in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
May an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. 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.
4,2853517F,,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
4,29135190,,Repair acq av fistula xtr,A,,13.08,4.12,NA,4.12,,3.34,20.54,20.54,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00