Billing code 35216: Vessel repairMedicare rate & RVUs in Washington
Report this code for direct surgical repair of a blood vessel in the chest when the repair is performed without bypass.
CMS doesn’t publish an office rate for 35216 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 35216 covers
This service covers direct operative repair of an intrathoracic blood vessel, such as repair of a vessel injured during chest trauma or another thoracic operation. A cardiothoracic or vascular surgeon typically performs it in an operating room as part of a major procedure. The repair addresses the vessel itself without a bypass; it is distinct from repair using a vein graft or another graft method.
Select the code based on the operative site, direct repair method, and whether bypass was used. The operative report should identify the vessel and chest location and describe the repair and any bypass or graft. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures at 50%. Modifier 50 identifies bilateral performance, paid at 150%. Assistant-at-surgery payment may be made; 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 35216 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $1,877.06 |
| Seattle (King Cnty) | Unavailable | $2,011.76 |
How the 35216 rate is calculated
Each of 35216’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 · 35216
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 35.69Practice expense 12.82Malpractice 8.60
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 35216
35216 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 35216
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 · 35216
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
35216 without 50 · national facility
$1,907.53
Vessel repair
35216-50 · Bilateral: 150%
$2,861.30
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).
35216 compared with similar codes
Compare codes
35216 vs 35211 vs 35246 vs 35221: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 35211Vessel repair
- Choose 35216 for direct intrathoracic repair without bypass; choose 35211 when bypass is used.
- 35246Vessel repair
- 35216 describes direct repair without a graft, while 35246 is for intrathoracic repair using a vein graft without bypass.
- 35221Vessel repair
- Both are direct repairs without bypass, but 35221 applies to an intra-abdominal vessel rather than an intrathoracic vessel.
35216 billing questions
How is 35216 different from 35211?
Both describe direct intrathoracic vessel repair, but 35216 is for repair without bypass. Use 35211 when the repair includes bypass.
When should a vein-graft repair be considered instead?
If the surgeon repairs the intrathoracic vessel using a vein graft, compare 35246 rather than reporting the direct-repair code.
What documentation supports 35216?
The operative report should identify the vessel and intrathoracic site and describe the direct repair, including whether bypass or a graft was used.
How does CMS handle bilateral reporting?
For bilateral performance, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
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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