Billing code 35121: Arterial repairMedicare rate & RVUs in Texas
Open direct repair of a visceral artery defect is reported when the surgeon repairs the affected abdominal artery rather than treating a rupture.
CMS doesn’t publish an office rate for 35121 in Texas.
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 35121 covers
This code represents open, direct repair of a defect in a visceral artery. A vascular or other qualified surgeon may perform the operation in a hospital operating room, for example to correct a localized arterial defect identified during treatment of an abdominal vascular condition. The operative report should identify the artery and defect, describe the repair performed, and distinguish a defect repair from treatment of a rupture or repair of a different named vessel.
Select the code based on the involved artery and the documented procedure; the rupture-specific visceral artery code is a nearby alternative when rupture is being repaired. This major surgery has a 90-day global period, including the day-before preoperative visit and related postoperative care during the following 90 days. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to standard multiple-procedure reduction. For bilateral procedures, modifier 50 is paid at 150%. Assistant-at-surgery payment may be allowed; co-surgeons and team surgery are 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 35121 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $1,417.56 |
| Beaumont | Unavailable | $1,404.96 |
| Brazoria | Unavailable | $1,385.96 |
| Dallas | Unavailable | $1,408.23 |
| Fort Worth | Unavailable | $1,410.17 |
| Galveston | Unavailable | $1,398.87 |
| Houston | Unavailable | $1,542.92 |
| Rest Of Texas | Unavailable | $1,403.88 |
How the 35121 rate is calculated
Each of 35121’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 · 35121
RVUs × geographic indexes × conversion factor
Work30.73
30.73 RVUs× 1.000 GPCI
Practice expense4.42
4.42 RVUs× 1.000 GPCI
Malpractice7.87
7.87 RVUs× 1.000 GPCI
Adjusted RVUs
43.0200
Conversion factor
$33.4009
Medicare rate
$1,436.91
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 35121
35121 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 35121
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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 0 | Not permitted. |
| 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 · 35121
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 50 · payment effect
With and without the modifier
35121 without 50 · national facility
$1,436.91
Arterial repair
35121-50 · Bilateral: 150%
$2,155.37
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
35121 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 35122Arterial repair
- 35121 describes direct repair of a visceral artery defect; 35122 is the corresponding code to consider when the documented condition is a visceral artery rupture.
- 35102Aortic repair
- 35102 applies to direct repair involving the abdominal aorta. Use 35121 when the repaired vessel is a visceral artery rather than the aorta.
- 35111Arterial repair
- 35111 is a site-specific arterial repair code for a different vessel. Base selection on the artery identified in the operative report, not simply the abdominal location.
35121 billing questions
How is this code distinguished from 35122?
Use 35121 for direct repair of a visceral artery defect. The nearby 35122 code is for repair of a visceral artery rupture; the operative documentation should support the clinical circumstance.
What documentation supports reporting 35121?
Document the specific visceral artery, the defect being repaired, and the direct repair performed. The record should make clear whether the operation addressed a defect or a rupture.
Can an assistant-at-surgery be reported?
CMS identifies assistant-at-surgery payment as potentially payable for this procedure. Co-surgeons and team surgery are not permitted.
What is included in the global period?
The 90-day global 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 rule, the highest-valued procedure is paid in full and other procedures are subject to reduction when performed in the same session.
How is a bilateral procedure handled?
CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%.
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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