CPT 35820
Global 090 ActiveExplore chest vessels
CPT 35820 Billing & Documentation Guide
CPT code 35820 (Explore chest 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 35.97, a non-facility practice expense RVU of 11.22, and a malpractice RVU of 8.82, a total non-facility RVU of 56.01 and facility RVU of 56.01. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $1869.25, though rates vary from $1651.18 to $2363.59 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 35820, 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 35820 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 35820 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 35820
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 35.97 | 35.97 |
| Practice Expense RVU | 11.22 | 11.22 |
| Malpractice RVU | 8.82 | 8.82 |
| Total RVU | 56.01 | 56.01 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 35820
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 | $1847.69 | $1847.69 | $1790.49 - $2031.89 | 29 |
| Florida | $2150.92 | $2150.92 | $2002.48 - $2336.59 | 3 |
| Georgia | $1913.24 | $1913.24 | $1886.87 - $1939.6 | 2 |
| Illinois | $2130.72 | $2130.72 | $2004.04 - $2262.57 | 4 |
| Michigan | $1967.97 | $1967.97 | $1876.18 - $2059.76 | 2 |
| North Carolina | $1739.33 | $1739.33 | $1739.33 - $1739.33 | 1 |
| New York | $2076.99 | $2076.99 | $1764.55 - $2270.97 | 5 |
| Ohio | $1840.54 | $1840.54 | $1840.54 - $1840.54 | 1 |
| Pennsylvania | $1894.24 | $1894.24 | $1823.85 - $1964.63 | 2 |
| Texas | $1850.63 | $1850.63 | $1812.21 - $1988.54 | 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 35820
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 35820 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 35820
What does CPT code 35820 mean? +
CPT code 35820 represents: Explore chest vessels. It's in the Surgery (Respiratory/Cardiovascular) category with a global period of 090.
What is the Medicare reimbursement for CPT 35820? +
The 2026 Medicare national average non-facility payment for CPT 35820 is $1869.25. Rates range from $1651.18 to $2363.59 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 35820? +
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 35820? +
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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