CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31

CPT 35111 RVU and Medicare Payment (2026)

Repair defect of artery — 25.62 work RVU, about $1,208.44 non-facility Medicare payment at the 2026 conversion factor.

Work RVU
25.62
PE RVU (non-facility)
4.01
PE RVU (facility)
4.01
MP RVU
6.55
Office payment
$1,208.44
Facility payment
$1,208.44

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 35111 in a non-facility setting with national GPCI: (25.62 + 4.01 + 6.55) × $33.4009 ≈ $1,208.44. The same code in a facility setting pays about $1,208.44 because facility PE RVU (4.01) replaces office PE RVU.

What changes by locality

GPCI moves 35111 non-facility payment from $1,051.43 to $1,548.44 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 35111?

25.62. 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 35111 in 2026?

About $1,208.44 non-facility ($1,208.44 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 (25.62) and malpractice RVU stay fixed; only practice expense changes (4.01 office vs 4.01 facility). That is the entire office-vs-facility payment gap.