CPT 35876
Global 090 ActiveRemoval of clot in graft
CPT 35876 Billing & Documentation Guide
CPT code 35876 (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 17.37, a non-facility practice expense RVU of 3.94, and a malpractice RVU of 4.33, a total non-facility RVU of 25.64 and facility RVU of 25.64. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $853.16, though rates vary from $750.79 to $1090.1 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 35876, 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 35876 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 35876 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 35876
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 17.37 | 17.37 |
| Practice Expense RVU | 3.94 | 3.94 |
| Malpractice RVU | 4.33 | 4.33 |
| Total RVU | 25.64 | 25.64 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 35876
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 | $835.12 | $835.12 | $811.79 - $911.28 | 29 |
| Florida | $993.75 | $993.75 | $923.36 - $1082.93 | 3 |
| Georgia | $879.63 | $879.63 | $869.95 - $889.31 | 2 |
| Illinois | $985.74 | $985.74 | $926.37 - $1048.41 | 4 |
| Michigan | $907.31 | $907.31 | $863.61 - $951.01 | 2 |
| North Carolina | $795.37 | $795.37 | $795.37 - $795.37 | 1 |
| New York | $951.12 | $951.12 | $806.87 - $1042.35 | 5 |
| Ohio | $846.11 | $846.11 | $846.11 - $846.11 | 1 |
| Pennsylvania | $868.9 | $868.9 | $837.65 - $900.15 | 2 |
| Texas | $847.26 | $847.26 | $828.04 - $914.5 | 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 35876
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 35876 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 35876
What does CPT code 35876 mean? +
CPT code 35876 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 35876? +
The 2026 Medicare national average non-facility payment for CPT 35876 is $853.16. Rates range from $750.79 to $1090.1 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 35876? +
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 35876? +
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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