No office rate
Both codes cover thoracic or abdominal fistula repair; choose 35189 for an acquired fistula and 35182 when the fistula is congenital.
On this page
CMS RVU26D · Effective 2026-10-01
35189 AV fistula repair Medicare reimbursement rates in Wisconsin
Open vascular surgery to close an acquired artery-to-vein communication in the thorax or abdomen, reported when operative repair targets that site. Compare 35189 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 35189 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
$1193.84
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 35189: Acquired thoracoabdominal arteriovenous fistula repair
Open vascular surgery to close an acquired artery-to-vein communication in the thorax or abdomen, reported when operative repair targets that site.
This code describes operative repair of an acquired abnormal connection between an artery and a vein located in the thorax or abdomen. Such fistulas may follow trauma or a prior procedure. A vascular surgeon typically performs the repair in an operating room, using an approach suited to the affected vessels and the fistula’s location. The operative report should establish that the fistula is acquired and identify its thoracic or abdominal site.
Report the service for the repair itself, not for a congenital fistula or one in the head, neck, or extremity. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 35189
- 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- 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 RVU29.23 · 71%
- Practice expense (office) RVU4.40 · 11%
- Malpractice RVU7.46 · 18%
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.
35189 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
No office rate
This code is for an acquired fistula in the head or neck. Use 35189 when the acquired fistula is in the thorax or abdomen.
No office rate
This code is for an acquired fistula in an extremity. Use 35189 for an acquired thoracic or abdominal fistula.
Compare 35189 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
$1193.84
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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 35189 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
4,290
- Code
- 35189
- Physician work
- 29.23
- Practice expense
- 4.40
- Malpractice
- 7.46
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 29.23 | × 1.000 | 29.2300 |
| Practice expense | 4.40 | × 0.958 | 4.2152 |
| Malpractice | 7.46 | × 0.308 | 2.2977 |
| Total RVUs | 35.7429 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wisconsin$1193.84
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 29.23 | 1 |
| Practice expense | 4.4 | 0.958 |
| Malpractice | 7.46 | 0.308 |
(29.23 × 1 + 4.4 × 0.958 + 7.46 × 0.308) × $33.4009 = $1193.84
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.
35189 billing questions
How do I distinguish this code from the congenital thoracoabdominal fistula repair code?
Use this code for an acquired fistula. The corresponding congenital code, 35182, is for a fistula documented as congenital.
Which anatomic sites qualify?
The fistula must be in the thorax or abdomen. Fistulas in the head or neck and in an extremity are represented by separate site-specific codes.
Can modifier 50 be used for bilateral repair?
No. The CMS facts specify that bilateral adjustment does not apply and modifier 50 is inappropriate for this code.
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 paid?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How does CMS handle other procedures performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
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.
4,28735182,,Rpr cgen av fistula thrx&abd,A,,30.92,11.85,NA,11.85,,7.78,50.55,50.55,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,28835184,,Rpr cgen av fistula xtr,A,,18.35,3.30,NA,3.30,,4.69,26.34,26.34,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,28935188,,Rpr acq av fistula head&neck,A,,17.55,12.86,NA,12.86,,7.41,37.82,37.82,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,29035189,,Rpr acq av fistula thrx&abd,A,,29.23,4.40,NA,4.40,,7.46,41.09,41.09,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,29135190,,Repair acq av fistula xtr,A,,13.08,4.12,NA,4.12,,3.34,20.54,20.54,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,29235201,,Repair blood vessel dir neck,A,,16.51,4.79,NA,4.79,,4.02,25.32,25.32,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,29335206,,Repair blood vessel dir uxtr,A,,13.49,5.06,NA,5.06,,3.13,21.68,21.68,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,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,,,,,,