Billing code 35231: Vascular repairMedicare rate & RVUs in Washington
Reports surgical reconstruction of a neck blood vessel using a vein graft when the vessel defect cannot be managed with direct repair alone.
CMS doesn’t publish an office rate for 35231 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 35231 covers
A vascular surgeon uses a vein graft to reconstruct a blood vessel in the neck when injury, disease, or removal of adjacent tissue leaves a defect that requires graft material. The repair may restore continuity across a segmental defect or reinforce a vessel wall defect. This service is generally performed in an operating room, often during treatment of a neck vascular injury or as part of a larger operation involving a neck vessel.
Select this code for the neck location and vein-graft method; a direct suture repair or repair using a non-vein graft belongs to a different code. The operative report should identify the vessel and neck site, the defect being repaired, why graft reconstruction was needed, and the vein graft used. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; 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 35231 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $1,078.18 |
| Seattle (King Cnty) | Unavailable | $1,157.67 |
How the 35231 rate is calculated
Each of 35231’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 · 35231
RVUs × geographic indexes × conversion factor
Work20.63
20.63 RVUs× 1.000 GPCI
Practice expense8.07
8.07 RVUs× 1.000 GPCI
Malpractice3.79
3.79 RVUs× 1.000 GPCI
Adjusted RVUs
32.4900
Conversion factor
$33.4009
Medicare rate
$1,085.20
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 35231
35231 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 35231
Vascular 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 · 35231
Vascular 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
35231 without 50 · national facility
$1,085.20
Vascular repair
35231-50 · Bilateral: 150%
$1,627.80
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).
35231 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 35201Vessel repair
- Choose 35201 for direct repair of a neck vessel without graft material. This code requires a vein graft to reconstruct the defect.
- 35261Vessel repair
- Both address graft repair of a neck vessel. The graft material distinguishes them: vein for this code, other graft material for 35261.
- 35236Vessel repair
- Both involve vein-graft vessel repair, but 35236 is for an upper-extremity site rather than a neck vessel.
35231 billing questions
When should this code be chosen instead of 35201?
Use this code when a neck vessel is reconstructed with a vein graft. Code 35201 describes direct vessel repair without graft material.
How does this differ from 35261?
Both describe graft-based repair in the neck, but this code is for a vein graft; 35261 is for a graft other than a vein.
What documentation supports the graft method?
Document the neck vessel and defect, why graft reconstruction was required, and that a vein graft was used. The operative report should distinguish graft repair from direct closure.
How is bilateral repair handled?
When the procedure is performed bilaterally and reported with modifier 50, CMS pays 150%.
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?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; 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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