CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 35011 RVU and Medicare Payment (2026)
Repair defect of artery — 18.12 work RVU, about $914.18 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 18.12
- PE RVU (non-facility)
- 4.56
- PE RVU (facility)
- 4.56
- MP RVU
- 4.69
- Office payment
- $914.18
- Facility payment
- $914.18
How the payment is calculated
Total RVU is work plus practice expense plus malpractice, each adjusted by its GPCI factor, then multiplied by the conversion factor. For 35011 in a non-facility setting with national GPCI: (18.12 + 4.56 + 4.69) × $33.4009 ≈ $914.18. The same code in a facility setting pays about $914.18 because facility PE RVU (4.56) replaces office PE RVU.
What changes by locality
GPCI moves 35011 non-facility payment from $799.38 to $1,159.95 across CMS localities — from Wisconsin to Miami. Check your exact locality in the GPCI calculator rather than using a state average.
Related codes
Checking a different code or locality? Open the full RVU calculator to run any of the 7,790 CPT/HCPCS codes with your own GPCI factors.
Frequently asked questions
What is the 2026 work RVU for CPT 35011?
18.12. Work RVU measures physician time, skill, and intensity — it does not change by setting or locality. Total payment adds practice expense and malpractice RVUs plus the conversion factor.
How much does Medicare pay for CPT 35011 in 2026?
About $914.18 non-facility ($914.18 facility) at national GPCI with the 2026 $33.4009 conversion factor. Your locality GPCI moves the number — see the range above.
Does the work RVU change between office and facility?
No. Work RVU (18.12) and malpractice RVU stay fixed; only practice expense changes (4.56 office vs 4.56 facility). That is the entire office-vs-facility payment gap.