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CMS RVU26D · Effective 2026-10-01

35231 Vascular repair Medicare reimbursement rates in Wisconsin

Reports surgical reconstruction of a neck blood vessel using a vein graft when the vessel defect cannot be managed with direct repair alone. Compare 35231 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 35231 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

$986.27

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.

Find 35231 in your payment locality →

Vascular surgery

About 35231: Neck vessel repair with vein graft

Reports surgical reconstruction of a neck blood vessel using a vein graft when the vessel defect cannot be managed with direct repair alone.

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.

CMS billing rules for 35231

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 RVU20.63 · 63%
  • Practice expense (office) RVU8.07 · 25%
  • Malpractice RVU3.79 · 12%

115

Medicare services in 2024 · #4770 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.

35231 compared with similar codes

Office rates for Wisconsin, from the same CMS release.

35201

Vessel repair

Direct repair, neck

No office rate

Choose 35201 for direct repair of a neck vessel without graft material. This code requires a vein graft to reconstruct the defect.

35261

Vessel repair

Neck, non-vein graft

No office rate

Both address graft repair of a neck vessel. The graft material distinguishes them: vein for this code, other graft material for 35261.

35236

Vessel repair

Upper extremity, vein graft

No office rate

Both involve vein-graft vessel repair, but 35236 is for an upper-extremity site rather than a neck vessel.

Compare 35231 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

Office and facility base rates · shared scale starting at $0

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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 35231 in Wisconsin.

PPRRVU2026_Oct_nonQPP.csv

4,300

Code
35231
Physician work
20.63
Practice expense
8.07
Malpractice
3.79

GPCI2026.csv

111

Locality
Wisconsin
Physician work
1.000
Practice expense
0.958
Malpractice
0.308
Facility calculation for 35231 in Wisconsin
ComponentRVULocality factorAdjusted
Physician work20.63× 1.00020.6300
Practice expense8.07× 0.9587.7311
Malpractice3.79× 0.3081.1673
Total RVUs29.5284
Conversion factor× 33.4009

Facility rate, Wisconsin$986.27

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.
Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work20.631
Practice expense8.070.958
Malpractice3.790.308

(20.63 × 1 + 8.07 × 0.958 + 3.79 × 0.308) × $33.4009 = $986.27

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.

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 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.

RVUs for 35231PPRRVU2026_Oct_nonQPP.csv, line 4,300 (RVU26D)
Geographic factors for WisconsinGPCI2026.csv, line 111 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet