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See a sample rate comparisonCPT 35870 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 Of Graft Complication, Surgery To Repair A Passageway (Fistula) That Has Developed Between A Blood Vessel Graft And Some Portion Of The Intestinal Area.
| 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 | 62 - Co-Surgeons 22 - Increased Procedural Services |
| Complexity Level | High |
| Medicare Fee Schedule | $1,135.63 national non-facility rate (2026) · View Medicare rates for 35870 |
| Medicaid Fee Schedule | $877.875 median of the 8 states in the free preview · View Medicaid rates for 35870 |
National average reimbursement for CPT 35870 by major payers:
$1,588.96
$1,759.61
$1,810.52
$2,008.26
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CPT 35870
5 of 25 sample ratesHigher to lower in this preview
Saint Lukes South Surgery Center LLC
$6,623.00Published rateFour Corners Ambulatory Surgery Center, LLC
$1,812.00Published rateSurgery Center Of Pembroke Pines, LLC
Surgery Center Of Pembroke
$1,049.00Published rateBloomington Normal Healthcare, LLC
Bloomington-Normal Healthcare, L.L.C.
$567.00Published rateEye Care Surgery Center Of Olive Branch,LLC
$320.00Published rate
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See a sample payer proposalCPT 35870 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 35870 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 35870 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 |
|---|---|---|
| 35700-CPT | Moderate | Reoperation Bypass Graft, Reoperation Femoral Popliteal Or Femoral Popliteal Anterior Tibial Posterior Tibial Peroneal Artery Or Other Distal Vessels More Than 1 Month After Original Operation List Separately In Addition To Code For Primary Procedure |
| 35820-CPT | High | Exploratory Surgery, Exploratory Surgery To Examine A Site For Possible Hemorrhage (Excessive Bleeding) Or Infection Complications Following The Initial Surgery. |
| 35860-CPT | Moderate | Exploratory Surgery, Exploratory Surgery To Examine A Site For Possible Hemorrhage (Excessive Bleeding) Or Infection Complications Following The Initial Surgery. |
| 35870-CPT | High | Repair Of Graft Complication, Surgery To Repair A Passageway (Fistula) That Has Developed Between A Blood Vessel Graft And Some Portion Of The Intestinal Area. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 35870. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 35870 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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