CPT 35011 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 • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 35011 |
National average reimbursement for CPT 35011 by major payers:
$1,422.25
$1,402.55
$1,446.59
$1,648.93
| 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 35011 | ||||||
United | 35011 | $4080.00 | 1710952841 - ANDOCHICK SURGICAL CENTER LLC, PHYSICIANS SURGERY CENTER OF FREDERICK | 522239166 - (MD) ANDOCHICK SURGICAL CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35011 | $4900.00 | 1962070896 - OAK ASC, LLC | 833101804 - (IL) OAK ASC LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35011 | $1000.00 | 1164516084 - ENDOSCOPIC AMBULATORY SPECIALTY CENTER OF BAY RIDGE INC | 113530475 - (NY) ENDOSCOPIC AMBULATORY SPECIALTY CENTER OF BAY RIDGE, INC. | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35011 | $5040.00 | 1578146429 - BSMH AMBULATORY VENTURES II LLC, MERCY HEALTH CANFIELD SURGERY CENTER | 863462441 - (OH) BSMH AMBULATORY VENTURES II LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35011 | $2715.00 | 1417903899 - JUPITER OUTPATIENT SURGERY CENTER LLC | 650925020 - (FL) JUPITER OUTPATIENT SURGERY CENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35011 | $2388.00 | 1457898215 - PROSPECT BLACKSTONE VALLEY SURGICARE, LLC, BLACKSTONE VALLEY SURGICARE | 814871794 - (RI) PROSPECT BLACKSTONE VALLEY SURGICARE LLC | RI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35011 | $2600.00 | 1811095136 - GROSSMONT OUTPATIENT SURGICAL CENTER | 953337109 - (CA) GROSSMONT OUTPATIENT SURGICAL CE | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35011 | $6588.00 | 1568967131 - CENTRAL MAINE EYE SURGERY CENTER LLC | 824811437 - (ME) CENTRAL MAINE EYE SURGERY CENTER LLC | ME | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35011 | $867.00 | 1871598300 - NOVAMED SURGERY CENTER OF COLUMBUS, LLC | 50540724 - (GA) NOVAMED SURGERY CENTER OF COLUMBUS LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35011 | $1950.00 | 1043391188 - SKIN SURGERY CENTER PS, SKIN SURGERY CENTER | 911954101 - (WA) SKIN SURGERY CENTER P. S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35011 | $4512.00 | 1952408783 - SHADYSIDE SURGI-CENTER, INC. | 251707086 - (PA) SHADYSIDE SURGICENTER INC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35011 | $671.00 | 1497831523 - BOSTON IVF, INC., THE SURGERY CENTER OF WALTHAM | 42921956 - (MA) BOSTON IVF, LLC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35011 | $965.00 | 1760849889 - SURGERY CENTER AT CORPORATE WAY LLC | 473812657 - (OH) SURGERY CENTER AT CORPORATE WAY LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35011 | $1500.00 | 1215410592 - ALLIANCE SURGERY CENTER AT WOODSTOCK, LLC | 830957221 - (GA) ALLIANCE SURGERY CENTER AT WOODSTOCK LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35011 | $3300.00 | 1295385482 - JOHNS HOPKINS SURGERY CENTERS SERIES | 208707724 - (MD) JOHNS HOPKINS SURGERY CENTER SERIES | MD | 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 35011 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 35011 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 35011 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 |
| 35002-CPT | High | Direct Repair Of Aneurysm, Pseudoaneurysm, Or Excision (Partial Or Total) And Graft Insertion, With Or Without Patch Graft; For Ruptured Aneurysm, Carotid, Subclavian Artery, By Neck Incision |
| 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 |
| 35013-CPT | High | Direct Repair Of Aneurysm, Pseudoaneurysm, Or Excision (Partial Or Total) And Graft Insertion, With Or Without Patch Graft; For Ruptured Aneurysm, Axillary-Brachial Artery, By Arm Incision |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 35011. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 35011 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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