Billing code 35286: Vessel repairMedicare rate & RVUs in Texas
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.
CMS doesn’t publish an office rate for 35286 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 35286 covers
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.
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 35286 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 | $834.70 |
| Beaumont | Unavailable | $819.03 |
| Brazoria | Unavailable | $813.62 |
| Dallas | Unavailable | $825.98 |
| Fort Worth | Unavailable | $826.43 |
| Galveston | Unavailable | $820.73 |
| Houston | Unavailable | $898.70 |
| Rest Of Texas | Unavailable | $820.78 |
How the 35286 rate is calculated
Each of 35286’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 · 35286
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 16.76Practice expense 4.18Malpractice 4.26
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 35286
35286 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 35286
Vessel 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) | 1 | Permitted with supporting documentation. |
| 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 · 35286
Vessel 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
35286 without 50 · national facility
$841.70
Vessel repair
35286-50 · Bilateral: 150%
$1,262.55
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).
35286 compared with similar codes
Compare codes
35286 vs 35256 vs 35226 vs 35266: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 35256Vessel repair
- Both address lower-extremity vessel repair with graft reconstruction. Choose 35256 for a vein graft and 35286 for graft material other than vein.
- 35226Vessel repair
- 35226 is for direct repair of a lower-extremity vessel; 35286 is for repair using graft material other than vein.
- 35266Vessel repair
- The graft material category is the same, but 35266 is for an upper-extremity vessel and 35286 is for a lower-extremity vessel.
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 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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