Billing code 35092: Aortic rupture repairMedicare rate & RVUs in Washington
Open operative repair of a ruptured thoracoabdominal aortic aneurysm, reported when the rupture involves the aorta across the chest and abdomen.
CMS doesn’t publish an office rate for 35092 in Washington.
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 35092 covers
This code represents open repair of a ruptured aneurysm involving the thoracoabdominal aorta, typically with reconstruction of the affected aortic segment using a graft. Vascular or cardiothoracic surgeons perform this major operation in a hospital operating room, generally as an emergency for a patient with acute aortic rupture. The operative report should establish the rupture and describe the aortic extent and reconstruction performed.
Select this code when the ruptured aneurysm involves the thoracoabdominal aorta; an abdominal-only rupture is represented by a different code. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures at 50%. Modifier 50 bilateral reporting is paid at 150%. An assistant at surgery may be paid; co-surgeon payment requires 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 35092 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $2,222.38 |
| Seattle (King Cnty) | Unavailable | $2,343.55 |
How the 35092 rate is calculated
Each of 35092’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 · 35092
RVUs × geographic indexes × conversion factor
Work49.70
49.70 RVUs× 1.000 GPCI
Practice expense6.19
6.19 RVUs× 1.000 GPCI
Malpractice12.71
12.71 RVUs× 1.000 GPCI
Adjusted RVUs
68.6000
Conversion factor
$33.4009
Medicare rate
$2,291.30
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 35092
35092 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 35092
Aortic rupture 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 · 35092
Aortic rupture 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
35092 without 50 · national facility
$2,291.30
Aortic rupture repair
35092-50 · Bilateral: 150%
$3,436.95
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).
35092 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 35082Aortic rupture repair
- Choose 35092 when the rupture involves the thoracoabdominal aorta; choose 35082 when the repair concerns a ruptured aneurysm of the abdominal aorta.
- 35091Artery repair
- Both codes concern the thoracoabdominal aorta. The distinguishing factor is rupture: 35092 is for a ruptured aneurysm, while 35091 is for a nonruptured aneurysm.
- 35081Aortic aneurysm repair
- 35081 describes nonruptured aneurysm repair involving the abdominal aorta; 35092 describes rupture repair involving the thoracoabdominal aorta.
35092 billing questions
How is this code distinguished from 35082?
Use 35092 for a ruptured aneurysm involving the thoracoabdominal aorta. Code 35082 describes rupture repair involving the abdominal aorta.
How does 35092 differ from 35091?
Both concern the thoracoabdominal aorta, but 35092 is for rupture repair. Code 35091 is for repair of an aneurysm that is not ruptured.
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?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; CMS does not permit team surgery for this code.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are paid at 50% under the standard multiple procedure reduction.
How is bilateral reporting handled?
When reported bilaterally with modifier 50, CMS pays this procedure 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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