CPT 35103 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 • 23 - Emergency Room |
| Common Modifiers | • None • 80 - Assistant surgeon • GC - Service performed by resident under supervision • 50 - Bilateral Procedure |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 35103 |
National average reimbursement for CPT 35103 by major payers:
$2,895.37
$3,135.96
$3,228.46
$3,635.28
| 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 35103 | ||||||
United | 35103 | $1049.00 | 1659748184 - SURGCENTER OF THE POTOMAC, LLC | 472311914 - (MD) SURGCENTER OF THE POTOMAC, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35103 | $400.00 | 1801220983 - THE MINIMALLY INVASIVE SPINE SURGERY CENTER OF PARADISE VALLEY, LLC | 461416301 - (AZ) THE MINIMALLY INVASIVE SPINE SURGERY CENTER OF PARADISE VALLEY LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35103 | $100.00 | 1376998666 - SWAN SURGERY CENTER, LLC | 812309409 - (AZ) SWAN SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35103 | $807.00 | 1063878734 - CESC, LLC | 811020132 | ME | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35103 | $470.00 | 1255846762 - APEX AMBULATORY SURGERY CENTER INC | 820823327 - (CA) APEX AMBULATORY SURGERY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35103 | $410.00 | 1740561018 - CHILDREN 1ST GRAND PRAIRIE, LLC, CHILDREN 1ST DENTAL & SURGERY CENTER | 453126800 - (TX) FIDUCIARY WISE, LLC FBO CHILDREN 1ST DENTAL & SURGERY CENTER | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35103 | $6068.00 | 1881620995 - MCKINNEY SURGERY CENTER, LP, THE SURGERY CENTRE AT CRAIG RANCH | 383897811 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35103 | $1080.00 | 1063595221 - SURGERY CENTER OF LOVELAND, LLC, LOVELAND SURGERY CENTER | 900985087 - (CO) SURGERY CENTER OF LOVELAND LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35103 | $418.00 | 1710112669 - NEWBRIDGE SURGERY CENTER AT WALDORF | 264650579 - (MD) NEWBRIDGE SURGERY CENTER AT WALDORF | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35103 | $1049.00 | 1528210770 - SOUTH COUNTY OUTPATIENT ENDOSCOPY SERVICES, LP, SCOPES ENDOSCOPY CENTER | 263374547 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35103 | $1028.00 | 1114302353 - POINT OF ROCKS SURGERY CENTER, LLC | 464992977 - (MD) POINT OF ROCKS SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35103 | $1028.00 | 1750499950 - MEDPLEX OUTPATIENT SURGERY CENTER LTD, MEDPLEX OUTPATIENT SURGERY CENTER | 760353620 - (AL) MEDPLEX OUTPATIENT SURGERY CENTER LTD | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35103 | $492.00 | 1467883496 - KILLER BEES LLC, BLUEGRASS SURGERY AND LASER CENTER | 201075292 | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35103 | $510.00 | 1770724122 - NATIONAL SURGICAL CENTERS OF AMERICA LLC, NSCOA | 264278807 - (FL) NATIONAL SURGICAL CENTERS OF AMERICA LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35103 | $2652.00 | 1063007573 - GEORGIA EYE SURGICENTER, LLC, GEORGIA EYE INSTITUTE SURGERY CENTER | 861925762 | GA | 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 35103 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 35103 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 35103 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 |
|---|---|---|
| 35102-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, Abdominal Aorta Involving Iliac Vessels (Common, Hypogastric, External) |
| 35103-CPT | High | Direct Repair Of Aneurysm, Pseudoaneurysm, Or Excision (Partial Or Total) And Graft Insertion, With Or Without Patch Graft; For Ruptured Aneurysm, Abdominal Aorta Involving Iliac Vessels (Common, Hypogastric, External) |
| 35111-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, Splenic Artery |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 35103. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 35103 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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