No office rate
35206 describes direct upper-extremity vessel repair without graft reconstruction. Use 35266 when the repair uses graft material other than a vein.
On this page
CMS RVU26D · Effective 2026-10-01
35266 Vessel repair Medicare reimbursement rates in Wyoming
Reports operative reconstruction of an upper-extremity blood vessel using graft material other than a vein, such as for a traumatic vessel defect. Compare 35266 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 35266 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
$753.89
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.
Vascular surgery
About 35266: Upper-extremity vessel repair with nonvein graft
Reports operative reconstruction of an upper-extremity blood vessel using graft material other than a vein, such as for a traumatic vessel defect.
Code 35266 represents operative reconstruction of an injured or surgically damaged upper-extremity blood vessel using graft material other than a vein. A vascular surgeon may use this approach when the vessel defect requires graft reconstruction rather than direct closure; a typical situation is repair of a traumatic arm vessel injury. The code identifies the graft category and upper-extremity site, not a particular named vessel or graft configuration. The service is generally performed in an operating room.
Select this code when the operative report supports both the upper-extremity location and use of nonvein graft material. Document the vessel, defect, graft material, and reconstruction performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. 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 35266
- 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 RVU15.43 · 65%
- Practice expense (office) RVU4.24 · 18%
- Malpractice RVU3.92 · 17%
141
Medicare services in 2024 · #4605 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.
35266 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
Both codes concern graft repair of an upper-extremity vessel, but 35236 is for a vein graft; 35266 is for other graft material.
No office rate
35286 describes nonvein-graft vessel repair in the lower extremity. The distinguishing factor is the anatomical site.
Compare 35266 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
Wyoming** →
Office / nonfacility
Unavailable
Facility
$753.89
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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 35266 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
4,307
- Code
- 35266
- Physician work
- 15.43
- Practice expense
- 4.24
- Malpractice
- 3.92
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 15.43 | × 1.000 | 15.4300 |
| Practice expense | 4.24 | × 1.000 | 4.2400 |
| Malpractice | 3.92 | × 0.740 | 2.9008 |
| Total RVUs | 22.5708 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$753.89
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 15.43 | 1 |
| Practice expense | 4.24 | 1 |
| Malpractice | 3.92 | 0.74 |
(15.43 × 1 + 4.24 × 1 + 3.92 × 0.74) × $33.4009 = $753.89
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.
35266 billing questions
When should 35266 be chosen over direct vessel repair?
Use 35266 when the upper-extremity vessel is reconstructed with graft material other than a vein. A direct repair without graft is represented by 35206.
How does a vein graft change the code choice?
For an upper-extremity vessel repair using a vein graft, compare 35236. Code 35266 identifies graft material other than a vein.
What operative documentation supports 35266?
Document the upper-extremity vessel and site, the defect being repaired, the graft material, and how the graft was used in the reconstruction.
How are bilateral procedures and other same-session procedures paid?
CMS pays bilateral reporting with modifier 50 at 150%. For multiple procedures in the same session, the highest-valued procedure is paid in full and the others at 50%.
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.
4,30435251,,Rpr blvsl vn grf intra-abdl,A,,31.11,7.91,NA,7.91,,7.85,46.87,46.87,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,30535256,,Repair blvsl vn grf lxtr,A,,18.58,4.67,NA,4.67,,4.52,27.77,27.77,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,30635261,,Rpr blvsl grf oth/thn vn nck,A,,18.49,3.65,NA,3.65,,4.73,26.87,26.87,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,30735266,,Rpr blvsl grf oth/th vn uxtr,A,,15.43,4.24,NA,4.24,,3.92,23.59,23.59,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,30835271,,Rpr blvs gr ot/th vn ntrth w,A,,23.97,9.89,NA,9.89,,5.73,39.59,39.59,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,30935276,,Rpr blvs gr ot/t vn ntrth wo,A,,25.18,10.54,NA,10.54,,6.03,41.75,41.75,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,31035281,,Rpr blvsl gr ot/th vn ntr-ab,A,,29.31,7.70,NA,7.70,,7.47,44.48,44.48,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,