CPT 35800
Global 090 ActiveExplore neck vessels
CPT 35800 Billing & Documentation Guide
CPT code 35800 (Explore neck vessels) is classified under Surgery (Respiratory/Cardiovascular) with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 11.7, a non-facility practice expense RVU of 5.76, and a malpractice RVU of 2.34, a total non-facility RVU of 19.8 and facility RVU of 19.8. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $666.46, though rates vary from $596.3 to $834.15 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 35800, 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 35800 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 35800 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 35800
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 11.7 | 11.7 |
| Practice Expense RVU | 5.76 | 5.76 |
| Malpractice RVU | 2.34 | 2.34 |
| Total RVU | 19.8 | 19.8 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 35800
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 | $674.83 | $674.83 | $650.19 - $753.1 | 29 |
| Florida | $735.97 | $735.97 | $692.19 - $788.73 | 3 |
| Georgia | $668.44 | $668.44 | $655.57 - $681.3 | 2 |
| Illinois | $727.42 | $727.42 | $688.6 - $766.25 | 4 |
| Michigan | $681.45 | $681.45 | $654.68 - $708.22 | 2 |
| North Carolina | $620.23 | $620.23 | $620.23 - $620.23 | 1 |
| New York | $730.21 | $730.21 | $628.51 - $789.69 | 5 |
| Ohio | $645.23 | $645.23 | $645.23 - $645.23 | 1 |
| Pennsylvania | $666.3 | $666.3 | $641.26 - $691.34 | 2 |
| Texas | $654.94 | $654.94 | $638.47 - $692.5 | 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 35800
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 35800 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 |
| 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 |
| 0904T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 35800
What does CPT code 35800 mean? +
CPT code 35800 represents: Explore neck vessels. It's in the Surgery (Respiratory/Cardiovascular) category with a global period of 090.
What is the Medicare reimbursement for CPT 35800? +
The 2026 Medicare national average non-facility payment for CPT 35800 is $666.46. Rates range from $596.3 to $834.15 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 35800? +
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 35800? +
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 April 21, 2026.
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