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See a sample rate comparisonCPT 34520 Fee Schedule
Last Verified: October 2026
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.
Reconstruct Vein Valve, Surgery To Reconstruct A Malfunctioning Valve Located In A Vein Anywhere In The Body. The Procedure May Involve Grafting A Replacement Or Connecting The Vein To Another Valve.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Cardiovascular System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital 11 - Office |
| Common Modifiers | LT - Left side of body RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | $903.16 national non-facility rate (2026) · View Medicare rates for 34520 |
| Medicaid Fee Schedule | $699.025 median of the 8 states in the free preview · View Medicaid rates for 34520 |
National average reimbursement for CPT 34520 by major payers:
$1,365.94
$1,402.85
$1,445.51
$1,592.77
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CPT 34520
5 of 25 sample ratesHigher to lower in this preview
Metropolitan Surgical Institute, LLC
Metropolitan Surgical Institute
$7,083.00Published rateThe Outpatient Center, LLC, The Outpatient Center Of Boynton Beach, Ltd.
The Outpatient Center Of Boynton Beach, Ltd.
$6,087.00Published rateKuresmart Pain Management Surgery Center, Clearway Surgery Center Of Dundalk
Kuresmart Pain Management Surgery Center
$4,189.00Published rateColumbia Surgical Specialists, Ps, Columbia Surgery Center
Columbia Surgical Specialists, P.S.
$2,677.00Published rateDes Peres Eye Surgery Center, LLC, St Louis Eye Surgery And Laser Center
Des Peres Eye Surgery Center, LLC
$1,170.00Published rate
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See a sample payer proposalCPT 34520 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 34520 code is part of the Surgery services used for Surgical Procedures on the Cardiovascular 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 34520 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.
| Code | Complexity | Description |
|---|---|---|
| 34490-CPT | Moderate | Blood Clot Removal, Surgery To Remove A Blood Clot From An Artery Or Vein In The Leg Arm Abdomen Or Neck. The Blood Vessel May Be Opened Up Or A Thin Tube (Catheter) Inserted Into The Vessel To Remove The Clot. |
| 34502-CPT | High | Reconstruction Of Vena Cava, Any Method |
| 34510-CPT | High | Reconstruct Vein Valve, Surgery To Reconstruct A Malfunctioning Valve Located In A Vein Anywhere In The Body. The Procedure May Involve Grafting A Replacement Or Connecting The Vein To Another Valve. |
| 34520-CPT | High | Reconstruct Vein Valve, Surgery To Reconstruct A Malfunctioning Valve Located In A Vein Anywhere In The Body. The Procedure May Involve Grafting A Replacement Or Connecting The Vein To Another Valve. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 34520. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 34520 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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