CPT 35111 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 • 50 - Federally Qualified Health Center |
| Common Modifiers | • None • 82 - Assistant surgeon - no qualified resident • AS - PA/NP/CNS assistant at surgery |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 35111 |
National average reimbursement for CPT 35111 by major payers:
$1,791.89
$1,896.30
$1,940.75
$2,192.64
| 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 35111 | ||||||
United | 35111 | $300.00 | 1184675704 - DOCTORS SURGERY CENTER LLC | 593518740 - (FL) DOCTORS SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35111 | $1028.00 | 1548203888 - NORTH VALLEY ORTHOPEDIC SURGERY CENTER LLC, THE ORTHOPEDIC SURGERY CENTER OF ARIZONA | 202684773 - (AZ) NORTH VALLEY ORTHOPEDIC SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35111 | $1215.00 | 1467057372 - SOUTHWEST CONNECTICUT SURGERY CENTER, LLC | 852607391 - (CT) SOUTHWEST CONNECTICUT SURGERY CENTER, LLC | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35111 | $1028.00 | 1649223124 - CAMP LOWELL SURGERY CENTER,LLC, CAMP LOWELL SURGERY CENTER | 201086556 - (AZ) CAMP LOWELL SURGERY CENTER | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35111 | $650.00 | 1730153073 - EAST MEMPHIS UROLOGY CENTER, LP, UROCENTER | 621810940 - (TN) EAST MEMPHIS UROLOGY CENTER LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35111 | $150.00 | 1053510933 - MONTGOMERY EYE SURGERY CENTER LLC, MONTGOMERY EYE SURGERY CENTER | 621607284 - (AL) MONTGOMERY EYE SURGERY CENTER LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35111 | $2705.00 | 1952364499 - DENTON REGIONAL AMBULATORY SURGERY CENTER, L.P., MEDICAL CITY SURGERY CENTER/DENTON | 200270605 - (TX) DENTON REGIONAL AMBULATORY SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35111 | $2416.00 | 1205364981 - MERCED AMBULATORY SURGERY CENTER, LLC, UNIVERSITY SURGERY CENTER | 611845381 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35111 | $1049.00 | 1295344026 - WEST CHESTER SURGICAL SUITES, LLC | 845072006 - (OH) WEST CHESTER SURGICAL SUITES LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35111 | $795.00 | 1407836315 - SPINE CARE DELAWARE, LLC | 510393046 - (DE) SPINE CARE DELAWARE LLC | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35111 | $2044.00 | 1164870895 - SUMMIT ORTHOPEDICS LTD, EAGAN SURGERY CENTER | 411762331 - SUMMIT ORTHOPEDICS, LTD. | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35111 | $390.00 | 1972853810 - UNIVERSITY OF HOUSTON SYSTEM, UH COLLEGE OF OPTOMETRY SURGERY CENTER | 746001399 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35111 | $1146.00 | 1386275147 - SURGERY CENTER OF MESA LLC | 813829555 - (AZ) SURGERY CENTER OF MESA LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35111 | $625.00 | 1235683798 - ASSOCIATED SURGICAL CENTER LLC | 813492018 - (IL) ASSOCIATED SURGICAL CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35111 | $655.00 | 1447212337 - PUGET SOUND GASTROENTEROLOGY, PLLC, EVERGREEN ENDOSCOPY CENTER | 911123468 - (WA) PUGET SOUND GASTROENTEROLOGY, P.S. | WA | 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 35111 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 35111 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 35111 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 |
|---|---|---|
| 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 |
| 35112-CPT | High | Direct Repair Of Aneurysm, Pseudoaneurysm, Or Excision (Partial Or Total) And Graft Insertion, With Or Without Patch Graft; For Ruptured Aneurysm, 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 35111. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 35111 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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