No office rate
Choose 35131 for a groin arterial defect repair; 35132 identifies repair of a ruptured artery in the groin.
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CMS RVU26D · Effective 2026-10-01
35131 Arterial repair Medicare reimbursement rates in Wisconsin
Reports direct surgical repair of an arterial defect in the groin, commonly involving the femoral artery, when the documented condition and site support this service. Compare 35131 office and facility rates across CMS payment localities in Wisconsin.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 35131 in Wisconsin?
Wisconsin has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1100.01
1 of 1 localities have a supported rate.
Payment area: Wisconsin
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Vascular surgery
About 35131: Direct groin artery defect repair
Reports direct surgical repair of an arterial defect in the groin, commonly involving the femoral artery, when the documented condition and site support this service.
A vascular surgeon performs open direct repair of an arterial defect in the groin, commonly involving the femoral artery. The service may address a localized aneurysm or pseudoaneurysm, with the surgeon repairing the affected vessel directly. It is generally performed in an operating room when the arterial condition requires surgical reconstruction; the operative report should identify the artery, the defect, and the repair performed.
Select this code for the groin-site defect repair, rather than the rupture-specific groin code when the artery is documented as ruptured. Documentation should make the site and condition clear and distinguish the repair from treatment of a traumatic arterial injury. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur 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.
CMS billing rules for 35131
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU25.74 · 68%
- Practice expense (office) RVU5.40 · 14%
- Malpractice RVU6.56 · 17%
140
Medicare services in 2024 · #4608 by national volume
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.
35131 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
No office rate
Both are arterial defect repair codes, but 35141 is associated with the thigh site rather than the groin.
No office rate
35226 describes direct repair of a lower-extremity blood vessel in a different clinical context, such as traumatic vessel injury, rather than the groin defect repair represented by 35131.
Compare 35131 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Wisconsin →
Office / nonfacility
Unavailable
Facility
$1100.01
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 35131 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
4,276
- Code
- 35131
- Physician work
- 25.74
- Practice expense
- 5.40
- Malpractice
- 6.56
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 25.74 | × 1.000 | 25.7400 |
| Practice expense | 5.40 | × 0.958 | 5.1732 |
| Malpractice | 6.56 | × 0.308 | 2.0205 |
| Total RVUs | 32.9337 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wisconsin$1100.01
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 25.74 | 1 |
| Practice expense | 5.4 | 0.958 |
| Malpractice | 6.56 | 0.308 |
(25.74 × 1 + 5.4 × 0.958 + 6.56 × 0.308) × $33.4009 = $1100.01
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
35131 billing questions
How does this differ from 35132?
35131 is for a groin-site arterial defect repair. Use 35132 when the operative documentation identifies rupture of the groin artery.
What should the operative report identify?
Document the artery and groin site, the condition being repaired, and the direct repair performed. The record should distinguish a defect repair from a ruptured artery or traumatic injury.
How are bilateral procedures reported?
CMS pays bilateral reporting with modifier 50 at 150%. The record should support repair on both sides.
Does the 90-day global period include postoperative visits?
Yes. The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
4,27335121,,Repair defect of artery,A,,30.73,4.42,NA,4.42,,7.87,43.02,43.02,0,090,0.09,0.84,0.07,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,27435122,,Repair artery rupture belly,A,,36.94,5.01,NA,5.01,,9.44,51.39,51.39,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,2753512F,,Syph scrng docd as done,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4,27635131,,Repair defect of artery,A,,25.74,5.40,NA,5.40,,6.56,37.70,37.70,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,27735132,,Repair artery rupture groin,A,,31.76,4.60,NA,4.60,,8.12,44.48,44.48,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,2783513F,,Hep b scrng docd as done,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4,27935141,,Repair defect of artery,A,,20.39,4.10,NA,4.10,,5.17,29.66,29.66,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,