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CMS RVU26D · Effective 2026-10-01

35246 Vessel repair Medicare reimbursement rates in Wyoming

Reports reconstruction of an intrathoracic blood vessel with a vein graft when the repair restores the vessel without creating a bypass route. Compare 35246 office and facility rates across CMS payment localities in Wyoming.

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 35246 in Wyoming?

Wyoming 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

$1426.77

1 of 1 localities have a supported rate.

Payment area: Wyoming**

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 35246 in your payment locality →

Vascular surgery

About 35246: Intrathoracic vessel repair with vein graft

Reports reconstruction of an intrathoracic blood vessel with a vein graft when the repair restores the vessel without creating a bypass route.

A surgeon uses a vein graft to repair a damaged or diseased blood vessel inside the chest, restoring continuity at the site rather than routing blood around it. This may be needed during open thoracic surgery for an injury or when removing a diseased vessel segment leaves a defect that requires graft reconstruction. Vascular, thoracic, or cardiothoracic surgeons typically perform the operation in a hospital operating room.

Select this code when the operative report supports both the intrathoracic location and use of a vein graft, and shows that the reconstruction is not a bypass. Document the vessel repaired, the graft material, and the repair performed. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care. For procedures 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 bilateral reporting is paid at 150%. Assistant-at-surgery payment may be available; co-surgeons require supporting documentation, and team surgery is not permitted.

CMS billing rules for 35246

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 RVU27.52 · 62%
  • Practice expense (office) RVU10.32 · 23%
  • Malpractice RVU6.59 · 15%

32

Medicare services in 2024 · #5619 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.

35246 compared with similar codes

Office rates for Wyoming, from the same CMS release.

35241

Vascular repair

Intrathoracic, vein graft with bypass

No office rate

Both use a vein graft for an intrathoracic vessel. Choose 35241 when the repair includes bypass; 35246 describes repair without bypass.

35216

Vessel repair

Intrathoracic, direct, no bypass

No office rate

This is intrathoracic direct vessel repair without bypass and without a vein graft. Use 35246 when a vein graft is used.

35276

Vessel repair

Intrathoracic, without bypass

No office rate

This describes intrathoracic repair without bypass using a graft other than a vein. Choose 35246 when the graft is a vein.

Compare 35246 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 35246 in Wyoming**.

PPRRVU2026_Oct_nonQPP.csv

4,303

Code
35246
Physician work
27.52
Practice expense
10.32
Malpractice
6.59

GPCI2026.csv

112

Locality
Wyoming**
Physician work
1.000
Practice expense
1.000
Malpractice
0.740
Facility calculation for 35246 in Wyoming**
ComponentRVULocality factorAdjusted
Physician work27.52× 1.00027.5200
Practice expense10.32× 1.00010.3200
Malpractice6.59× 0.7404.8766
Total RVUs42.7166
Conversion factor× 33.4009

Facility rate, Wyoming**$1426.77

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
Work27.521
Practice expense10.321
Malpractice6.590.74

(27.52 × 1 + 10.32 × 1 + 6.59 × 0.74) × $33.4009 = $1426.77

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.

35246 billing questions

How does this differ from 35241?

Both describe intrathoracic vessel repair using a vein graft. Use 35246 when the reconstruction is without bypass; 35241 is the with-bypass counterpart.

When would direct vessel repair be more appropriate?

If the surgeon repairs the intrathoracic vessel directly without using a graft, consider 35216 when the repair is without bypass.

What operative documentation supports 35246?

The report should identify the intrathoracic vessel, the vein graft used, and how the graft reconstructs the vessel without creating a bypass route.

How is bilateral reporting handled?

When the procedure is performed bilaterally, modifier 50 applies; CMS pays the bilateral procedure at 150%.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be available. Co-surgeons are paid only with supporting documentation; team surgery is not permitted.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

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 35246PPRRVU2026_Oct_nonQPP.csv, line 4,303 (RVU26D)
Geographic factors for Wyoming**GPCI2026.csv, line 112 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet