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See a sample rate comparisonCPT 35251 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 Ves.W Graft; Intra-Abdomina
| 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 | 82 - Assistant surgeon - no qualified resident 51 - Multiple procedures |
| Complexity Level | High |
| Medicare Fee Schedule | $1,565.50 national non-facility rate (2026) · View Medicare rates for 35251 |
| Medicaid Fee Schedule | $1,215.65 median of the 8 states in the free preview · View Medicaid rates for 35251 |
National average reimbursement for CPT 35251 by major payers:
$2,387.92
$2,385.00
$2,540.05
$2,752.18
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CPT 35251
5 of 25 sample ratesHigher to lower in this preview
Texas Health Surgery Center Alliance, LLC, Texas Health Surgery Center Alliance
$6,068.00Published rateSurgery Centre Of Sw Florida LLC, Fort Myers Surgery Center
$983.00Published rateOrland Park Surgical Center LLC
Orland Park Surgical Center, LLC
$530.00Published rateUrology Health Surgery Center, LLC
Urology Health Surgery Center LLC
$250.00Published rateIndiana Skin Cancer Ambulatory Surgical Center LLC
$80.00Published rate
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See a sample payer proposalCPT 35251 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 35251 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 35251 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 35251. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 35251 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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