CPT 35103
Global 090 ActiveRepair artery rupture aorta
CPT 35103 Billing & Documentation Guide
CPT code 35103 (Repair artery rupture aorta) is classified under Surgery (Respiratory/Cardiovascular) with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 42.53, a non-facility practice expense RVU of 5.45, and a malpractice RVU of 10.89, a total non-facility RVU of 58.87 and facility RVU of 58.87. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $1950.88, though rates vary from $1706.96 to $2529.93 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 35103, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 35103 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
90-day global period (major surgery: 1 day pre-op + procedure + 90 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 35103 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 35103
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 42.53 | 42.53 |
| Practice Expense RVU | 5.45 | 5.45 |
| Malpractice RVU | 10.89 | 10.89 |
| Total RVU | 58.87 | 58.87 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 35103
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $1884.1 | $1884.1 | $1839.16 - $2034.26 | 29 |
| Florida | $2311.26 | $2311.26 | $2141.26 - $2529.93 | 3 |
| Georgia | $2031.55 | $2031.55 | $2016.49 - $2046.6 | 2 |
| Illinois | $2296.5 | $2296.5 | $2155.26 - $2448.2 | 4 |
| Michigan | $2103.43 | $2103.43 | $1997.4 - $2209.46 | 2 |
| North Carolina | $1822.81 | $1822.81 | $1822.81 - $1822.81 | 1 |
| New York | $2185.49 | $2185.49 | $1849.18 - $2403.35 | 5 |
| Ohio | $1953.38 | $1953.38 | $1953.38 - $1953.38 | 1 |
| Pennsylvania | $2000.47 | $2000.47 | $1931.38 - $2069.55 | 2 |
| Texas | $1945.43 | $1945.43 | $1896.02 - $2113.17 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 35103
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 35103 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0078T | Column 1 (primary), can be billed with modifier | No | Mutually exclusive procedures |
| 0080T | Column 1 (primary), can be billed with modifier | No | Mutually exclusive procedures |
| 0153T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0154T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0254T | Column 1 (primary), can be billed with modifier | No | Mutually exclusive procedures |
| 0553T | Column 1 (primary), can be billed with modifier | No | Mutually exclusive procedures |
Frequently Asked Questions, CPT 35103
What does CPT code 35103 mean? +
CPT code 35103 represents: Repair artery rupture aorta. It's in the Surgery (Respiratory/Cardiovascular) category with a global period of 090.
What is the Medicare reimbursement for CPT 35103? +
The 2026 Medicare national average non-facility payment for CPT 35103 is $1950.88. Rates range from $1706.96 to $2529.93 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 35103? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 35103? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 7, 2026.
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