Billing code 35182: AV fistula repairMedicare rate & RVUs in Oklahoma

Reports open surgical correction of a congenital artery-to-vein connection located in the thorax or abdomen, with repair tailored to the involved anatomy.

CMS RVU26DEffective Oct 1, 20261 payment locality

CMS doesn’t publish an office rate for 35182 in Oklahoma.

—Office (non-facility)
$1,588.12Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 35182 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Oklahoma
  2. What 35182 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 35182 covers

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.

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 in Oklahoma

35182 office and facility rates by payment locality
Payment localityOfficeFacility
OklahomaUnavailable$1,588.12

How the 35182 rate is calculated

Each of 35182’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 · 35182

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 30.92Practice expense 11.85Malpractice 7.78

50.5500 adjusted RVUs×$33.4009 conversion factor=$1,688.42

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 35182

35182 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 35182

AV fistula repair

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.84/0.07Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 35182

AV fistula 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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

35182 without 51 · national facility

$1,688.42

AV fistula repair

35182-51 · Second procedure: 50%

$844.21

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%).

When to use modifier 51

35182 compared with similar codes

Compare codes

35182 vs 35189 vs 35180 vs 35184: national Medicare rates

Swap in your local Medicare rate.

  • 35182
    AV fistula repair · 30.92 wRVU
    —
  • 35189
    AV fistula repair · 29.23 wRVU
    —
  • 35180
    AV fistula repair · 14.72 wRVU
    —
  • 35184
    Fistula repair · 18.35 wRVU
    —

How to choose

35189AV fistula repair
Both concern the thorax or abdomen, but 35182 is for congenital origin and 35189 is for acquired origin.
35180AV fistula repair
This code is for congenital fistula repair in the thorax or abdomen; 35180 is for the head or neck.
35184Fistula repair
This code is for congenital fistula repair in the thorax or abdomen; 35184 is for an extremity.

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 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
RVUs for 35182PPRRVU2026_Oct_nonQPP.csv, line 4,287 (RVU26D)
Geographic factors for OklahomaGPCI2026.csv, line 86 (RVU26D)

Open CMS sourceHow we calculate rates

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