CPT 15936 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Integumentary System |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital • 99 - Other POS |
| Common Modifiers | • None • 58 - Staged or related procedure during postoperative period • 59 - Distinct Procedural Service |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 15936 |
National average reimbursement for CPT 15936 by major payers:
$1,035.93
$1,158.22
$1,111.87
$1,457.82
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 15936 | ||||||
United | 15936 | $463.00 | 1336272657 - ARIZONA DIGESTIVE CENTER, P.C. | 201544723 - (AZ) ARIZONA DIGESTIVE CENTER PC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15936 | $449.00 | 1811385883 - CENTRAL DELAWARE ENDOSCOPY UNIT LLC | 471840129 | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15936 | $832.00 | 1841507266 - SOUTH PORTLAND SURGICAL CENTER LLC, SOUTH PORTLAND SURGICAL CENTER | 800461691 - (OR) SOUTH PORTLAND SURGICAL CENTER, LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15936 | $1276.00 | 1851396014 - ARC WORCESTER CENTER, L.P. | 621772057 - (MA) ARC WORCESTER CENTER LP | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15936 | $1528.00 | 1689188823 - FLORIDA ORTHOPAEDIC INSTITUTE SURGERY CENTER LLC | 593646134 - (FL) FLORIDA ORTHOPAEDIC INSTITUTE SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15936 | $600.00 | 1255872784 - MIDATLANTIC ENDOSCOPY LLC, MID-ATLANTIC GASTROINTESTINAL CENTER | 814079161 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15936 | $1595.00 | 1760568273 - WALLA WALLA CLINIC, INC., WALLA WALLA CLINIC AMBULATORY SURGERY CENTER | 910862542 - WALLA WALLA CLINIC, INC. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15936 | $1357.00 | 1003168907 - CANDESCENT EYE HEALTH SURGICENTER, LLC | 460608742 | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15936 | $640.00 | 1255373676 - EYE SURGERY CENTERS OF NEW MEXICO, LLC, SURGERY CENTER OF SANTA FE | 850478109 - (NM) EYE SURGERY CENTERS OF NEW MEXICO LLC | NM | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15936 | $2355.00 | 1699702050 - VIRGINIA MASON MEDICAL CENTER, VIRGINIA MASON BELLEVUE ASC | 910565539 - (WA) VIRGINIA MASON MEDICAL CENTER | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15936 | $507.00 | 1881319127 - PRIME SURGERY CENTER | 872283379 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15936 | $2480.00 | 1518344043 - MEMORIAL HERMANN SURGERY CENTER KIRBY, LLC, MEMORIAL HERMANN SURGERY CENTER KIRBY GLEN | 364801162 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15936 | $834.00 | 1568840528 - ALPHARETTA SURGERY CENTER LLC | 208459286 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15936 | $1558.00 | 1518359181 - ARAPAHOE SURGICENTER, LLC | 472388780 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15936 | $748.00 | 1407251622 - MASSAC COUNTY SURGERY CENTER LLC, THE ORTHOPAEDIC INSTITUTE SURGERY CENTER | 464314954 - (IL) MASSAC COUNTY SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 15936 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 15936 code is part of the Surgery services used for Surgical Procedures on the Integumentary System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 15936 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 15936. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 15936 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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