CPT 35875
Global 090 ActiveRemoval of clot in graft
CPT 35875 Billing & Documentation Guide
CPT code 35875 (Removal of clot in graft) is classified under Surgery (Respiratory/Cardiovascular) with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 10.45, a non-facility practice expense RVU of 3.03, and a malpractice RVU of 2.64, a total non-facility RVU of 16.12 and facility RVU of 16.12. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $537.27, though rates vary from $473.15 to $679.93 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 35875, 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 35875 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 35875 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 35875
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 10.45 | 10.45 |
| Practice Expense RVU | 3.03 | 3.03 |
| Malpractice RVU | 2.64 | 2.64 |
| Total RVU | 16.12 | 16.12 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 35875
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 | $529.12 | $529.12 | $513.16 - $580.63 | 29 |
| Florida | $622.24 | $622.24 | $578.32 - $677.4 | 3 |
| Georgia | $551.62 | $551.62 | $544.42 - $558.81 | 2 |
| Illinois | $616.56 | $616.56 | $579.26 - $655.56 | 4 |
| Michigan | $568.18 | $568.18 | $540.99 - $595.37 | 2 |
| North Carolina | $499.81 | $499.81 | $499.81 - $499.81 | 1 |
| New York | $598.38 | $598.38 | $507.17 - $655.46 | 5 |
| Ohio | $530.32 | $530.32 | $530.32 - $530.32 | 1 |
| Pennsylvania | $545.57 | $545.57 | $525.27 - $565.87 | 2 |
| Texas | $532.5 | $532.5 | $520.9 - $573.66 | 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 35875
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 35875 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 |
| 0632T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 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 |
Frequently Asked Questions, CPT 35875
What does CPT code 35875 mean? +
CPT code 35875 represents: Removal of clot in graft. It's in the Surgery (Respiratory/Cardiovascular) category with a global period of 090.
What is the Medicare reimbursement for CPT 35875? +
The 2026 Medicare national average non-facility payment for CPT 35875 is $537.27. Rates range from $473.15 to $679.93 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 35875? +
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 35875? +
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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