Billing code 35256: Vessel repairMedicare rate & RVUs in Washington
Report this operation when a surgeon repairs a lower-extremity blood vessel using a vein graft to restore continuity across a defect.
CMS doesn’t publish an office rate for 35256 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 35256 covers
A surgeon uses this service to reconstruct a blood vessel in the lower limb with a vein graft, such as when an injury or a segmental defect prevents repair by direct suturing. It is typically performed in an operating room by a vascular, trauma, or other surgeon treating the affected vessel. The operative report should identify the lower-extremity site and vessel, describe the defect and repair technique, and document use of a vein graft.
Choose this code for a vein-graft repair in the lower extremity; direct vessel repair is represented by a different code, and repairs using other graft material have a separate code. CMS classifies the service as major surgery with a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons are paid only with 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 35256 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $907.80 |
| Seattle (King Cnty) | Unavailable | $966.35 |
How the 35256 rate is calculated
Each of 35256’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 · 35256
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 18.58Practice expense 4.67Malpractice 4.52
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 35256
35256 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 35256
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 · 35256
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
35256 without 50 · national facility
$927.54
Vessel repair
35256-50 · Bilateral: 150%
$1,391.31
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).
35256 compared with similar codes
Compare codes
35256 vs 35226 vs 35236 vs 35286: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 35226Vessel repair
- Both concern lower-extremity vessel repair. Choose 35226 when the repair is direct and does not use a graft; choose this code when a vein graft is used.
- 35236Vessel repair
- Both describe vessel repair with a vein graft, but 35236 is for the upper extremity; this code is for the lower extremity.
- 35286Vessel repair
- Both are for lower-extremity vessel repair with a graft. The distinction is graft material: vein for this code, other graft material for 35286.
35256 billing questions
When should this be chosen instead of direct vessel repair?
Use this code when the lower-extremity vessel repair uses a vein graft. A direct repair without a graft is represented by 35226.
Is this a bypass code?
No. It represents repair of a lower-extremity vessel using a vein graft, rather than a bypass procedure.
How should bilateral repairs be reported?
For a bilateral procedure, report modifier 50; CMS pays this service at 150% under the supplied fee schedule rule.
What operative documentation supports this code?
Document the lower-extremity vessel and site, the defect or injury, the repair performed, and that a vein graft was used.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and related postoperative care during the 90-day period are included in the global service.
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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