CPT 35251
Global 090 ActiveRpr blvsl vn grf intra-abdl
CPT 35251 Billing & Documentation Guide
CPT code 35251 (Rpr blvsl vn grf intra-abdl) is classified under Surgery (Respiratory/Cardiovascular) with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 31.11, a non-facility practice expense RVU of 7.91, and a malpractice RVU of 7.85, a total non-facility RVU of 46.87 and facility RVU of 46.87. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $1560.49, though rates vary from $1372.96 to $1984.5 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 35251, 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 35251 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 2 units of 35251 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 35251
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 31.11 | 31.11 |
| Practice Expense RVU | 7.91 | 7.91 |
| Malpractice RVU | 7.85 | 7.85 |
| Total RVU | 46.87 | 46.87 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 35251
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 | $1531.15 | $1531.15 | $1486.87 - $1674.92 | 29 |
| Florida | $1814.59 | $1814.59 | $1685.76 - $1977.23 | 3 |
| Georgia | $1606.43 | $1606.43 | $1587.31 - $1625.55 | 2 |
| Illinois | $1799.08 | $1799.08 | $1690.13 - $1913.64 | 4 |
| Michigan | $1656.23 | $1656.23 | $1576.34 - $1736.12 | 2 |
| North Carolina | $1453.15 | $1453.15 | $1453.15 - $1453.15 | 1 |
| New York | $1739.58 | $1739.58 | $1474.42 - $1906.64 | 5 |
| Ohio | $1544.61 | $1544.61 | $1544.61 - $1544.61 | 1 |
| Pennsylvania | $1587.53 | $1587.53 | $1529.41 - $1645.64 | 2 |
| Texas | $1548.47 | $1548.47 | $1513.75 - $1670.55 | 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 35251
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 35251 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 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 |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0645T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0903T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 35251
What does CPT code 35251 mean? +
CPT code 35251 represents: Rpr blvsl vn grf intra-abdl. It's in the Surgery (Respiratory/Cardiovascular) category with a global period of 090.
What is the Medicare reimbursement for CPT 35251? +
The 2026 Medicare national average non-facility payment for CPT 35251 is $1560.49. Rates range from $1372.96 to $1984.5 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 35251? +
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 35251? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
Get the full PayerReady toolkit
Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.
Start free →Run this code through our claim audit tool
Check NCCI bundling, MUE limits, and modifier logic before submission.
Try the auditor →Did this page help?
Quick signal so we know what to improve.
If you want a code reference page that doesn't exist yet, email coding@payerready.com.
Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.
Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team