No office rate
Choose 35201 for direct repair of a neck vessel without graft material. This code requires a vein graft to reconstruct the defect.
On this page
CMS RVU26D · Effective 2026-10-01
35231 Vascular repair Medicare reimbursement rates in Pennsylvania
Reports surgical reconstruction of a neck blood vessel using a vein graft when the vessel defect cannot be managed with direct repair alone. Compare 35231 office and facility rates across CMS payment localities in Pennsylvania.
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 35231 in Pennsylvania?
Pennsylvania 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
$1056.13–$1133.08
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 35231: Neck vessel repair with vein graft
Reports surgical reconstruction of a neck blood vessel using a vein graft when the vessel defect cannot be managed with direct repair alone.
A vascular surgeon uses a vein graft to reconstruct a blood vessel in the neck when injury, disease, or removal of adjacent tissue leaves a defect that requires graft material. The repair may restore continuity across a segmental defect or reinforce a vessel wall defect. This service is generally performed in an operating room, often during treatment of a neck vascular injury or as part of a larger operation involving a neck vessel.
Select this code for the neck location and vein-graft method; a direct suture repair or repair using a non-vein graft belongs to a different code. The operative report should identify the vessel and neck site, the defect being repaired, why graft reconstruction was needed, and the vein graft used. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care. For multiple procedures 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 available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 35231
- 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 RVU20.63 · 63%
- Practice expense (office) RVU8.07 · 25%
- Malpractice RVU3.79 · 12%
115
Medicare services in 2024 · #4770 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.
35231 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
Both address graft repair of a neck vessel. The graft material distinguishes them: vein for this code, other graft material for 35261.
No office rate
Both involve vein-graft vessel repair, but 35236 is for an upper-extremity site rather than a neck vessel.
Compare 35231 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
Metropolitan Philadelphia →
Office / nonfacility
Unavailable
Facility
$1133.08
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$1056.13
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35231 billing questions
When should this code be chosen instead of 35201?
Use this code when a neck vessel is reconstructed with a vein graft. Code 35201 describes direct vessel repair without graft material.
How does this differ from 35261?
Both describe graft-based repair in the neck, but this code is for a vein graft; 35261 is for a graft other than a vein.
What documentation supports the graft method?
Document the neck vessel and defect, why graft reconstruction was required, and that a vein graft was used. The operative report should distinguish graft repair from direct closure.
How is bilateral repair handled?
When the procedure is performed bilaterally and reported with modifier 50, CMS pays 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. 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.
4,29735216,,Rpr blvsl dir ntrthrc wo byp,A,,35.69,12.82,NA,12.82,,8.60,57.11,57.11,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,29835221,,Rpr bld vsl dir intra-abdl,A,,25.95,7.58,NA,7.58,,6.54,40.07,40.07,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,29935226,,Repair blood vessel dir lxtr,A,,14.92,3.98,NA,3.98,,3.75,22.65,22.65,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,30035231,,Repair blvsl vn grf neck,A,,20.63,8.07,NA,8.07,,3.79,32.49,32.49,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,30135236,,Repair blvsl vn grf uxtr,A,,17.57,5.66,NA,5.66,,4.23,27.46,27.46,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,30235241,,Rpr blvsl vn grf ntrthrc w/b,A,,24.94,10.10,NA,10.10,,5.98,41.02,41.02,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,30335246,,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