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See a sample rate comparisonCPT 35180 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.
Surgery To Repair Blood Vessel, Surgery To Repair An Abnormal Passageway (Fistula) Between An Artery And Vein That Has Been Present Since Birth.
| 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 | 79 - Unrelated procedure - postop period |
| Complexity Level | High |
| Medicare Fee Schedule | $717.12 national non-facility rate (2026) · View Medicare rates for 35180 |
| Medicaid Fee Schedule | $615.48 median of the 8 states in the free preview · View Medicaid rates for 35180 |
National average reimbursement for CPT 35180 by major payers:
$1,034.93
$1,204.59
$1,203.91
$1,322.46
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CPT 35180
5 of 25 sample ratesHigher to lower in this preview
Ochsner Medical Center, Ochsner Outpatient Surgery Suite
Ochsner Clinic Foundation
$3,113.00Published rateAdvanced Center For Surgery, The Advanced Center For Surgery
Advanced Center For Surgery
$1,158.00Published rateMichigan Outpatient Surgical Solutions, LLC
Michigan Outpatient Surgical Solutions LLC
$934.00Published rateCoral Desert Surgery Center LLC
$397.00Published rateEye Surgicenter LLC
$206.00Published rate
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See a sample payer proposalCPT 35180 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 35180 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 35180 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 |
|---|---|---|
| 35152-CPT | High | Repair Rupture Of Large Artery, Surgery To Repair A Ruptured (Burst) Segment Of A Large Or Medium-Sized Artery In The Neck Arm Leg Or Abdomen. An Artificial Material May Be Used To Patch Up The Artery. |
| 35180-CPT | High | Surgery To Repair Blood Vessel, Surgery To Repair An Abnormal Passageway (Fistula) Between An Artery And Vein That Has Been Present Since Birth. |
| 35182-CPT | High | Surgery To Repair Blood Vessel, Surgery To Repair An Abnormal Passageway (Fistula) Between An Artery And Vein That Has Been Present Since Birth. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 35180. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 35180 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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