No office rate
Both address lower-extremity vessel repair with graft reconstruction. Choose 35256 for a vein graft and 35286 for graft material other than vein.
On this page
CMS RVU26D · Effective 2026-10-01
35286 Vessel repair Medicare reimbursement rates in Pennsylvania
Open lower-extremity vessel reconstruction using a graft other than vein is reported when the surgeon repairs a vessel defect with non-vein graft material. Compare 35286 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 35286 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
$822.43–$884.96
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 35286: Lower-extremity vessel repair with non-vein graft
Open lower-extremity vessel reconstruction using a graft other than vein is reported when the surgeon repairs a vessel defect with non-vein graft material.
A vascular surgeon uses this service for open reconstruction of a lower-extremity blood vessel when the repair requires graft material other than vein. A typical setting is the operating room during treatment of a vessel damaged by trauma or an operative injury. The graft bridges or replaces the affected portion as part of the vessel repair; this is distinct from closing a defect with direct sutures or reconstructing it with a vein graft.
Report the code when the operative record identifies the vessel and lower-extremity site, describes the defect and reconstruction, and documents the graft material. CMS 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 others at 50%. For bilateral procedures reported with modifier 50, payment is at 150%. Assistant-at-surgery services may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 35286
- 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 RVU16.76 · 67%
- Practice expense (office) RVU4.18 · 17%
- Malpractice RVU4.26 · 17%
527
Medicare services in 2024 · #3511 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.
35286 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
35226 is for direct repair of a lower-extremity vessel; 35286 is for repair using graft material other than vein.
No office rate
The graft material category is the same, but 35266 is for an upper-extremity vessel and 35286 is for a lower-extremity vessel.
Compare 35286 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
$884.96
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$822.43
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35286 billing questions
How is this different from 35256?
Both codes describe lower-extremity vessel repair using a graft, but 35286 is for graft material other than vein. Use 35256 when a vein graft is used.
When would 35226 be more appropriate?
35226 describes direct repair of a lower-extremity vessel. This code fits when the surgeon reconstructs the vessel with non-vein graft material rather than direct closure.
What documentation supports choosing this code?
The operative report should identify the lower-extremity vessel, the defect, the repair performed, and the graft material. The material should be documented as something other than vein.
How should bilateral repairs be reported?
For a bilateral procedure, report modifier 50; CMS payment is at 150%.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only when supporting documentation is provided; team surgery is not permitted.
How does the multiple-procedure rule affect payment?
When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%.
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.
4,30835271,,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
4,31035281,,Rpr blvsl gr ot/th vn ntr-ab,A,,29.31,7.70,NA,7.70,,7.47,44.48,44.48,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,31135286,,Rpr blvsl grf oth/th vn lxtr,A,,16.76,4.18,NA,4.18,,4.26,25.20,25.20,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,31235301,,Rechanneling of artery,A,,20.63,4.72,NA,4.72,,5.36,30.71,30.71,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,31335302,,Rechanneling of artery,A,,20.82,4.19,NA,4.19,,5.30,30.31,30.31,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,31435303,,Rechanneling of artery,A,,23.01,4.48,NA,4.48,,5.85,33.34,33.34,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00