No office rate
Both describe exploration without repair, but 35800 concerns vessels in the neck; this code concerns an extremity artery.
On this page
CMS RVU26D · Effective 2026-10-01
35860 Artery exploration Medicare reimbursement rates in Wisconsin
Reports open exploration of an extremity artery for a suspected vascular problem when the exploration ends without surgical repair. Compare 35860 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 35860 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
$683.74
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 35860: Extremity artery exploration without repair
Reports open exploration of an extremity artery for a suspected vascular problem when the exploration ends without surgical repair.
A surgeon exposes and examines an artery in an arm or leg to investigate a suspected problem such as bleeding or injury. The service is performed in an operative setting, commonly by a vascular surgeon, and is reported when the exploration does not lead to surgical repair. If the surgeon identifies a problem and repairs it, the definitive procedure—not exploration without repair—describes the work performed.
Choose this code for exploration of an extremity artery, rather than exploration of vessels in the neck, chest, or abdomen. The operative report should identify the extremity site, the reason for exploration, the findings, and that no repair was performed. This major surgery has a 90-day global period, including the day-before preoperative visit and 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 50% reduction. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 35860
- 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 RVU14.87 · 64%
- Practice expense (office) RVU4.66 · 20%
- Malpractice RVU3.69 · 16%
2K
Medicare services in 2024 · #2453 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.
35860 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
No office rate
This code is for an extremity artery. Use 35840 for exploration of vessels in the abdomen.
No office rate
This code describes exploration without repair. Code 35870 concerns repair of a defect in a blood vessel graft.
Compare 35860 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
$683.74
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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 35860 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
4,418
- Code
- 35860
- Physician work
- 14.87
- Practice expense
- 4.66
- Malpractice
- 3.69
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 14.87 | × 1.000 | 14.8700 |
| Practice expense | 4.66 | × 0.958 | 4.4643 |
| Malpractice | 3.69 | × 0.308 | 1.1365 |
| Total RVUs | 20.4708 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wisconsin$683.74
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 14.87 | 1 |
| Practice expense | 4.66 | 0.958 |
| Malpractice | 3.69 | 0.308 |
(14.87 × 1 + 4.66 × 0.958 + 3.69 × 0.308) × $33.4009 = $683.74
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.
35860 billing questions
When should this code be chosen instead of an extremity artery repair code?
Use it when the surgeon explores an extremity artery but does not perform a surgical repair. If a repair is performed, report the applicable definitive repair procedure instead.
Can exploration be reported separately when the surgeon repairs the artery?
This code describes exploration that is not followed by surgical repair. Do not use it to separately report the exploration leading to a repair.
Can modifier 50 be used when both limbs are explored?
No. CMS identifies bilateral adjustment as inappropriate for this code. Report the services according to the operative work and applicable coding rules.
How does the 90-day global period affect postoperative care?
The global period includes the day-before preoperative visit and 90 days of related postoperative care.
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 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.
4,41535800,,Explore neck vessels,A,,11.70,5.76,NA,5.76,,2.34,19.80,19.80,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,41635820,,Explore chest vessels,A,,35.97,11.22,NA,11.22,,8.82,56.01,56.01,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,41735840,,Explore abdominal vessels,A,,20.23,8.38,NA,8.38,,5.02,33.63,33.63,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,41835860,,Explore limb vessels,A,,14.87,4.66,NA,4.66,,3.69,23.22,23.22,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,41935870,,Repair vessel graft defect,A,,23.89,4.00,NA,4.00,,6.11,34.00,34.00,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,42035875,,Removal of clot in graft,A,,10.45,3.03,NA,3.03,,2.64,16.12,16.12,0,090,0.09,0.84,0.07,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,42135876,,Removal of clot in graft,A,,17.37,3.94,NA,3.94,,4.33,25.64,25.64,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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,,,,,,