No office rate
Choose 35022 when the service is repair of an artery rupture in the chest. This code describes direct repair of an intrathoracic arterial defect.
On this page
CMS RVU26D · Effective 2026-10-01
35021 Arterial repair Medicare reimbursement rates in Virginia
Direct repair of an arterial wall defect in the chest is reported for operative treatment of an intrathoracic artery defect. Compare 35021 office and facility rates across CMS payment localities in Virginia.
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 35021 in Virginia?
Virginia 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
$1153.09–$1323.59
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 35021: Direct repair of intrathoracic artery defect
Direct repair of an arterial wall defect in the chest is reported for operative treatment of an intrathoracic artery defect.
This code describes a surgeon’s direct repair of an arterial wall defect in the chest. It is selected for an intrathoracic artery rather than a neck or limb artery; the specific vessel and defect should be clear in the operative report. Vascular surgeons typically perform the service in a hospital operating room as part of an open procedure.
The record should identify the artery, the defect repaired, and the work performed. This major surgery code includes the preoperative visit on the day before surgery and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation. Team surgery is not permitted.
CMS billing rules for 35021
- 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 RVU21.62 · 60%
- Practice expense (office) RVU9.42 · 26%
- Malpractice RVU5.16 · 14%
21
Medicare services in 2024 · #5891 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.
35021 compared with similar codes
Office rates for Virginia, from the same CMS release.
No office rate
35091 is for a defect of the thoracic aorta. Use this code for the direct repair of a defect in another intrathoracic artery.
No office rate
35001 identifies direct repair of an arterial defect in the neck; this code identifies an intrathoracic site.
Compare 35021 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
Dc + Md/Va Suburbs →
Office / nonfacility
Unavailable
Facility
$1323.59
Virginia →
Office / nonfacility
Unavailable
Facility
$1153.09
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35021 billing questions
How is this distinguished from 35022?
35021 is for direct repair of an intrathoracic arterial defect. 35022 identifies repair of an artery rupture in the chest.
What should the operative report document?
Document the intrathoracic artery involved, the defect repaired, and the direct repair performed. This supports choosing the chest-vessel service rather than a neck or limb artery code.
Can modifier 50 be used for bilateral repair?
When the procedure is performed bilaterally, CMS pays the service reported with modifier 50 at 150%.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures in that session are subject to the standard 50% 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 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.
4,2553500F,,Cd4+cell cnt/% docd as done,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4,25635011,,Repair defect of artery,A,,18.12,4.56,NA,4.56,,4.69,27.37,27.37,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,25735013,,Repair artery rupture arm,A,,22.65,3.88,NA,3.88,,5.78,32.31,32.31,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,25835021,,Repair defect of artery,A,,21.62,9.42,NA,9.42,,5.16,36.20,36.20,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,25935022,,Repair artery rupture chest,A,,25.06,10.12,NA,10.12,,6.01,41.19,41.19,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,2603502F,,Hiv rna vrl ld <lmts quantif,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4,2613503F,,Hiv rna vrl ldnot<lmts quntf,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00