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 |
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 | $1367.00 | 1346289428 - PROLIANCE SURGEONS, INC., P.S., PROLIANCE SURGEONS SEATTLE ORTHOPEDIC CENTER-ASC | 911606533 - (WA) PROLIANCE SURGEONS, INC., P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15936 | $1039.00 | 1104933696 - WEST LAKES SURGERY CENTER LLC | 205345295 - (IA) WEST LAKES SURGERY CENTER, LLC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15936 | $829.00 | 1922093293 - LEWIS & CLARK ORTHOPAEDIC INSTITUTE LLC | 352210163 - LEWIS & CLARK ORTHOPAEDIC, LLC 401(K) PLAN | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15936 | $1438.00 | 1942230024 - LUTHERVILLE ENDOSCOPY CENTER LLC | 823193901 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15936 | $3787.00 | 1326046822 - SOUTH EMERSON SURGERY CENTER, LLC | 352087260 - (IN) SOUTH EMERSON SURGERY CENTER, LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15936 | $538.00 | 1013048461 - GASTROENTEROLOGY DIAGNOSTIC CENTER MEDICAL GROUP, A PROFESSIONAL, GASTROENTEROLOGY DIAGNOSTIC CENTER | 953921090 - (CA) GASTROENTEROLOGY DIAGNOSTIC CENTER MEDICAL GROUP A PROFESSIONAL | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15936 | $5532.00 | 1396700159 - DOCTORS SAME DAY SURGERY CENTER, LTD | 621614361 - (FL) DOCTORS SAME DAY SURGERY CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15936 | $434.00 | 1477876696 - KEY BISCAYNE SURGERY CENTER LLC | 271725488 - (FL) KEY BISCAYNE SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15936 | $433.00 | 1275501512 - NORTHWEST KANSAS SURGERY CENTER, LLC | 481209668 - (KS) NORTHWEST KANSAS SURGERY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15936 | $1809.00 | 1417534207 - MEDICAL CITY SURGERY CENTER OF FRISCO, LLC | 822432064 - (TX) MEDICAL CITY SURGERY CENTER OF FRISCO LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15936 | $400.00 | 1346693124 - VILLAGES ENDOSCOPY CENTER LLC | 813250494 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15936 | $1352.00 | 1720407273 - BRONX SC LLC, EMPIRE STATE AMBULATORY SURGERY CENTER | 273045919 - (NY) BRONX SC LLC DBA EMPIRE STATE AMBULATORY SURGERY CENTER | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15936 | $1258.00 | 1063099190 - ASCENSION SAINT THOMAS LEBANON SURGERY CENTER LLC, LEBANON SURGERY CENTER | 862679471 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15936 | $1000.00 | 1316082365 - WEST WILSHIRE MEDICAL SURGICAL CENTER INC. | 954421811 - (CA) WEST WILSHIRE MEDICAL SURGICAL C | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15936 | $1081.00 | 1700842507 - ARCADIA OUTPATIENT SURGERY CENTER LP | 752285078 - (CA) ARCADIA OUTPATIENT SURGERY CENTER LP | CA | 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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