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See a sample rate comparisonCPT 35188 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Repair Blood Vessel Injury, Surgery To Repair An Abnormal Passageway (Fistula) Between An Artery And Vein Created By An Injury.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Cardiovascular System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | GC - Service performed by resident under supervision 78 - Return to OR - related procedure 58 - Staged or related procedure during postoperative period |
| Complexity Level | High |
| Medicare Fee Schedule | $1,263.22 national non-facility rate (2026) · View Medicare rates for 35188 |
| Medicaid Fee Schedule | $957.025 median of the 8 states in the free preview · View Medicaid rates for 35188 |
National average reimbursement for CPT 35188 by major payers:
$1,466.57
$1,583.76
$1,733.57
$1,913.73
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CPT 35188
5 of 25 sample ratesHigher to lower in this preview
Northern Virginia Surgery Center LLC
$10,249.00Published rateSummit Ambulatory Surgical Center, LLC
$6,365.00Published rateOrthopaedic Institute For Children Ambulatory Surgery Center, LLC
Orthopaedic Institute For Children Ambulatory Surgery Center LLC
$3,000.00Published rateMercer County Surgery Center LLC, Mercer County Surgery Center
Mercer County Surgery Center, LLC
$1,704.00Published ratePrince Georges Multi Specialty Surgery Center
$1,078.00Published rate
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See a sample payer proposalCPT 35188 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 35188 code is part of the Surgery services used for Surgical Procedures on the Cardiovascular System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 35188 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 35184-CPT | High | Surgery To Repair Blood Vessel, Surgery To Repair An Abnormal Passageway (Fistula) Between An Artery And Vein That Has Been Present Since Birth. |
| 35188-CPT | High | Repair Blood Vessel Injury, Surgery To Repair An Abnormal Passageway (Fistula) Between An Artery And Vein Created By An Injury. |
| 35189-CPT | High | Rpair Acquired Or Traumatic Arterioveno Fistula; Thorax & Abdome, Repair Acquired Or Traumatic Arteriovenous Fistula; Thorax And Abdome |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 35188. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 35188 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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