Billing code 35251: Vessel repairMedicare rate & RVUs in Washington
Reports operative repair of an intra-abdominal blood vessel using a vein graft, such as during reconstruction after vessel injury or resection.
CMS doesn’t publish an office rate for 35251 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 35251 covers
This code describes surgical reconstruction of a blood vessel within the abdomen when the repair uses a vein graft. Vascular surgeons commonly perform it during open abdominal operations for vessel injury or when a segment must be reconstructed after disease or tumor resection. The operative report should identify the vessel and its abdominal location, the defect or reason for reconstruction, and the vein graft used.
Select this code when the documented repair uses a vein graft; a direct repair or repair using another graft material belongs to a different code. The procedure has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in the same 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%. 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 35251 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $1,530.35 |
| Seattle (King Cnty) | Unavailable | $1,629.45 |
How the 35251 rate is calculated
Each of 35251’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 · 35251
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 31.11Practice expense 7.91Malpractice 7.85
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 35251
35251 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 35251
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 · 35251
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
35251 without 50 · national facility
$1,565.50
Vessel repair
35251-50 · Bilateral: 150%
$2,348.25
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).
35251 compared with similar codes
Compare codes
35251 vs 35221 vs 35281 vs 35231: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 35221Vessel repair
- Both address intra-abdominal vessel repair, but 35221 is for direct repair. Choose 35251 when the operative report documents a vein graft.
- 35281Vessel repair
- Both are intra-abdominal vessel repairs using a graft; 35251 specifies a vein graft, while 35281 is for another graft material.
- 35231Vascular repair
- This is the corresponding vein-graft repair code for a vessel in the neck. The abdominal location distinguishes 35251.
35251 billing questions
How does this differ from 35221?
This code is for an intra-abdominal vessel repair using a vein graft. Code 35221 describes direct repair without a graft.
When would 35281 be considered instead?
Use 35281 when the intra-abdominal vessel repair uses a graft other than a vein graft. The operative report should support the graft material used.
What documentation supports reporting this code?
Document the abdominal vessel repaired, the reason for reconstruction, and that a vein graft was used. The operative details should distinguish graft reconstruction from direct closure.
How is the 90-day global period applied?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
How are multiple procedures and bilateral reporting handled?
For procedures in the same session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. 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
Fee sheets
Put 35251 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →