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See a sample rate comparisonCPT 35261 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 W Graft Other Than V
| 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 59 - Distinct Procedural Service |
| Complexity Level | High |
| Medicare Fee Schedule | $897.48 national non-facility rate (2026) · View Medicare rates for 35261 |
| Medicaid Fee Schedule | $769.315 median of the 8 states in the free preview · View Medicaid rates for 35261 |
National average reimbursement for CPT 35261 by major payers:
$1,349.17
$1,407.85
$1,458.93
$1,597.60
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CPT 35261
5 of 25 sample ratesHigher to lower in this preview
Spalding Triangle Surgery Center, LLC, Spalding Triangle Surgery Center
Spalding Triangle Surgery Center LLC
$6,263.00Published rateSouth Kansas City Surgical Center, Lc, South Kansas City Surgicenter
South Kansas City Surgical Center, LLC
$2,825.00Published rateGastroenterology Associates Endoscopy Center, LLC
Gastroenterology Assoc. Endoscopy Center, LLC. Dba Redding Endoscopy
$2,011.00Published rateDelmar Surgical Center LLC
$1,267.00Published rateDcr Surgery Center, LLC
Dcr Surgery Center LLC
$830.00Published rate
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See a sample payer proposalCPT 35261 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 35261 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 35261 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 35261. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 35261 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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