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See a sample rate comparisonCPT 35190 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-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 | RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $686.05 national non-facility rate (2026) · View Medicare rates for 35190 |
| Medicaid Fee Schedule | $533.515 median of the 8 states in the free preview · View Medicaid rates for 35190 |
National average reimbursement for CPT 35190 by major payers:
$971.19
$1,061.08
$1,095.03
$1,225.86
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CPT 35190
5 of 25 sample ratesHigher to lower in this preview
The Western Pennsylvania Hospital, Forbes Regional Campus
Highmark Health
$14,500.62Published ratePhoenix Orthopaedic Ambulatory Center, LLC, Gateway Surgery Center
Phoenix Orthopaedic Ambulatory Center, LLC
$5,846.00Published rateEyes On Stark Surgery Center, LLC, Vista Surgical Center
Eyes On Stark Surgery Center, LLC Dba Vista Surgical Center
$3,200.00Published rateEye Surgical Specialists Of New Jersey, Surgery Center Of Central New Jersey
Eye Surgical Specialists Of New Jersey
$1,933.00Published rateEye Surgical Center Of Mississippi
$875.00Published rate
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See a sample payer proposalCPT 35190 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 35190 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 35190 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 |
|---|---|---|
| 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. |
| 35201-CPT | High | Rep Vessel Neck |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 35190. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 35190 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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