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See a sample rate comparisonCPT 35201 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.
Rep Vessel Neck
| 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 | RT - Right side of body 59 - Distinct Procedural Service |
| Complexity Level | High |
| Medicare Fee Schedule | $845.71 national non-facility rate (2026) · View Medicare rates for 35201 |
| Medicaid Fee Schedule | $713.355 median of the 8 states in the free preview · View Medicaid rates for 35201 |
National average reimbursement for CPT 35201 by major payers:
$1,316.37
$1,311.64
$1,378.84
$1,507.99
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CPT 35201
5 of 25 sample ratesHigher to lower in this preview
Texas Health Spine Surgery Center Allen, LLC
Texas Health Spine Surgery Center Allen LLC
$8,818.00Published rateSurgcenter Of Southern Maryland, LLC
Surgcenter Of Southern Maryland
$6,492.00Published rateDay Surgery Center Of North Texas Ltd
$4,234.00Published rateRadiance-A Private Outpatient Surgery Center LLC, Radiance Surgery Center
Radiance, LLC
$2,500.00Published rateAdvanced Colon Care Inc, Shoreline Colonoscopy Suites
Advanced Colon Care Inc
$658.00Published rate
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See a sample payer proposalCPT 35201 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 35201 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 35201 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 35201. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 35201 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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