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See a sample rate comparisonCPT 35189 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.
Rpair Acquired Or Traumatic Arterioveno Fistula; Thorax & Abdome, Repair Acquired Or Traumatic Arteriovenous Fistula; Thorax And Abdome
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Cardiovascular System |
| Common Place of Service | 21 - Inpatient Hospital 23 - Emergency Room |
| Common Modifiers | 51 - Multiple procedures AG - Primary physician |
| Complexity Level | High |
| Medicare Fee Schedule | $1,372.44 national non-facility rate (2026) · View Medicare rates for 35189 |
| Medicaid Fee Schedule | $1,060.33 median of the 8 states in the free preview · View Medicaid rates for 35189 |
National average reimbursement for CPT 35189 by major payers:
$1,930.46
$2,146.85
$2,195.26
$2,480.93
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CPT 35189
5 of 25 sample ratesHigher to lower in this preview
Ku Medwest Ambulatory Surgery Center, LLC
Ku Medwest Ambulatory Surgery Center LLC
$3,563.00Published rateGastroenterology Associates, LLC, Gastroenterology Associates Endoscopy Center
Gastroenterology Associates PLLC
$1,064.00Published rateEnt Surgery Center Of Atlanta,LLC
Ent Surgery Center Of Atlantallc
$878.00Published rateBellingham Urology Group, PLLC
$654.00Published rateAkdhc Surgery Center, LLC
$100.00Published rate
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See a sample payer proposalCPT 35189 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 35189 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 35189 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 |
|---|---|---|
| 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 |
| 35190-CPT | Moderate | Repair Blood Vessel Injury, Surgery To Repair An Abnormal Passageway (Fistula) Between An Artery And Vein Created By An Injury. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 35189. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 35189 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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