CPT 35860
Global 090 ActiveExplore limb vessels
CPT 35860 Billing & Documentation Guide
CPT code 35860 (Explore limb 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 14.87, a non-facility practice expense RVU of 4.66, and a malpractice RVU of 3.69, a total non-facility RVU of 23.22 and facility RVU of 23.22. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $774.76, though rates vary from $683.74 to $978.68 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 35860, 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 35860 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 35860 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 35860
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 14.87 | 14.87 |
| Practice Expense RVU | 4.66 | 4.66 |
| Malpractice RVU | 3.69 | 3.69 |
| Total RVU | 23.22 | 23.22 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 35860
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 | $765.49 | $765.49 | $741.77 - $841.81 | 29 |
| Florida | $892.76 | $892.76 | $830.71 - $970.4 | 3 |
| Georgia | $793.37 | $793.37 | $782.42 - $804.32 | 2 |
| Illinois | $884.33 | $884.33 | $831.42 - $939.43 | 4 |
| Michigan | $816.3 | $816.3 | $777.93 - $854.67 | 2 |
| North Carolina | $720.65 | $720.65 | $720.65 - $720.65 | 1 |
| New York | $861.42 | $861.42 | $731.18 - $942.4 | 5 |
| Ohio | $763.01 | $763.01 | $763.01 - $763.01 | 1 |
| Pennsylvania | $785.36 | $785.36 | $756.03 - $814.68 | 2 |
| Texas | $767.12 | $767.12 | $751.03 - $824.79 | 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 35860
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 35860 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 35860
What does CPT code 35860 mean? +
CPT code 35860 represents: Explore limb vessels. It's in the Surgery (Respiratory/Cardiovascular) category with a global period of 090.
What is the Medicare reimbursement for CPT 35860? +
The 2026 Medicare national average non-facility payment for CPT 35860 is $774.76. Rates range from $683.74 to $978.68 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 35860? +
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 35860? +
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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