CPT 35005 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 Cardiovascular System |
| Common Place of Service | • 21 - Inpatient Hospital • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • RT - Right side of body • 59 - Distinct Procedural Service • 50 - Bilateral Procedure |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 35005 |
National average reimbursement for CPT 35005 by major payers:
$1,441.73
$1,438.57
$1,472.75
$1,670.09
| 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 35005 | ||||||
United | 35005 | $238.00 | 1023115078 - MAIN LINE PA ENDOSCOPY ASC LP, MAIN LINE ENDOSCOPY CENTER MALVERN | 205301211 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35005 | $704.00 | 1366908469 - BRUNSWICK SURGERY CENTER LLC | 824022728 - (NC) BRUNSWICK SURGERY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35005 | $970.00 | 1699421024 - INFIRMARY ASC | 871922333 - (AL) INFIRMARY ASC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35005 | $529.00 | 1346237237 - LUFKIN ENDOSCOPY CENTER LTD | 204411582 - (TX) LUFKIN ENDOSCOPY CENTER LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35005 | $2164.00 | 1568776615 - CEDAR PARK SURGERY CENTER, LLC | 272533497 - (TX) CEDAR PARK SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35005 | $320.00 | 1396828323 - EYE CARE SURGERY CENTER OF MEMPHIS, LLC | 470920340 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35005 | $1492.00 | 1457379158 - HUDSON CROSSING SURGERY CENTER, LLC, HUDSON CROSSING SURGERY CENTER | 364533553 - (NJ) HUDSON CROSSING SURGICAL CENTER | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35005 | $406.00 | 1558807131 - MIDWEST NEPHROLOGY ASSOCIATES, SC, MNA SURGERY CENTER | 391707770 - (WI) MIDWEST NEPHROLOGY ASSOCIATES, SC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35005 | $345.00 | 1427078930 - RETINA CONSULTANTS SURGERY CENTER | 223314785 - (NJ) RETINA CONSULTANTS SURGERY CENTER | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35005 | $424.00 | 1346215316 - CHESAPEAKE EYE SURGERY CENTER, LLC | 522310068 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35005 | $590.00 | 1699328146 - ALLIANCE SURGERY CENTER, LLC | 824278461 - (MI) ALLIANCE SURGERY CENTER | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35005 | $1274.00 | 1538773890 - ASC OF TRINITY, COMPREHENSIVE OUTPATIENT JOINT AND SPINE INSTITUTE | 833008593 - (FL) ASC OF TRINITY | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35005 | $624.00 | 1538336219 - PACIFIC CATARACT AND LASER INSTITUTE INC PC | 911394965 - PACIFIC CATARACT AND LASER INSTITUTE, INC., PC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35005 | $1200.00 | 1780218305 - THE UNIVERSITY OF TEXAS AT AUSTIN, UT HEALTH AUSTIN AMBULATORY SURGERY CENTER | 746000203 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35005 | $353.00 | 1386604908 - MATTAX NEU PRATER SURGERY CENTER, LLC | 431842771 - (MO) MATTAX NEU PRATER SURGERY CENTER LLC | MO | 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 35005 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 35005 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 35005 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 |
|---|---|---|
| 35001-CPT | High | Direct Repair Of Aneurysm, Pseudoaneurysm, Or Excision (Partial Or Total) And Graft Insertion, With Or Without Patch Graft; For Aneurysm And Associated Occlusive Disease, Carotid, Subclavian Artery, By Neck Incision |
| 35005-CPT | High | Direct Repair Of Aneurysm, Pseudoaneurysm, Or Excision (Partial Or Total) And Graft Insertion, With Or Without Patch Graft; For Aneurysm, Pseudoaneurysm, And Associated Occlusive Disease, Vertebral Artery |
| 35011-CPT | High | Direct Repair Of Aneurysm, Pseudoaneurysm, Or Excision (Partial Or Total) And Graft Insertion, With Or Without Patch Graft; For Aneurysm And Associated Occlusive Disease, Axillary-Brachial Artery, By Arm Incision |
| 35021-CPT | High | Direct Repair Of Aneurysm, Pseudoaneurysm, Or Excision (Partial Or Total) And Graft Insertion, With Or Without Patch Graft; For Aneurysm, Pseudoaneurysm, And Associated Occlusive Disease, Innominate, Subclavian Artery, By Thoracic Incision |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 35005. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 35005 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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