CPT 35211 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 • 51 - Multiple procedures • AS - PA/NP/CNS assistant at surgery |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 35211 |
National average reimbursement for CPT 35211 by major payers:
$1,882.32
$1,918.72
$1,999.10
$2,281.31
| 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 35211 | ||||||
United | 35211 | $340.00 | 1245201425 - ANDRE J GOLINO MD AND ASSOCIATES PA, PALM BEACH EYE CLINIC | 592348880 - (FL) ANDRE J GOLINO MD AND ASSOCIATES PA | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35211 | $2847.00 | 1063720365 - WASATCH FRONT SURGERY CENTER LLC | 800612279 | UT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35211 | $2600.00 | 1215930078 - MARIN HEALTH VENTURES, LLC, MARIN SPECIALTY SURGERY CENTER | 943377073 - (CA) MARIN HEALTH VENTURES, INC. DBA MARIN SPECIALTY SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35211 | $1262.00 | 1053336602 - VIRGINIA EYE INSTITUTE INC, VIRGINIA EYE INSTITUTE SURGERY PAVILION | 541420580 - (VA) VIRGINIA EYE INSTITUTE INC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35211 | $662.00 | 1588620306 - SPECIALTY ORTHOPAEDICS SURGERY CENTER | 201170147 - (GA) SPECIALTY ORTHOPAEDICS SURGERY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35211 | $916.00 | 1891395661 - SPINE SOLUTIONS OF SHEBOYGAN LLC | 853646323 - (WI) SPINE SOLUTIONS OF SHEBOYGAN LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35211 | $508.00 | 1780206292 - GREECE ASC, LLC, CORNERSTONE SURGERY CENTER | 824108616 - (NY) GREECE ASC LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35211 | $646.00 | 1821167479 - EVERGREEN EYE CENTER, PLLC, EVERGREEN EYE SURGERY CENTER | 911628032 - (WA) EVERGREEN EYE CENTER, INC. P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35211 | $1836.00 | 1437427333 - TOWER CLOCK SURGERY CENTER LLC | 453636581 - (WI) TOWER CLOCK SURGERY CENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35211 | $610.00 | 1093726796 - ROCKY MOUNTAIN EYE SURGERY CENTER INC | 810493712 - (MT) ROCKY MOUNTAIN EYE SURGERY CENTER INC | MT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35211 | $825.00 | 1497746747 - PHYSICIANS' SURGERY CENTER OF VICTORVILLE LLC | 260057464 - (CA) PHYSICIANS SURGERY CENTER OF VICTORVILLE, LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35211 | $983.00 | 1366982845 - JACKSONVILLE ENDOSCOPY CENTERS LLC, JACKSONVILLE CENTER FOR ENDOSCOPY | 384016302 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35211 | $559.00 | 1619487782 - UCH VASCULAR ACCESS ASC LLC | 820975009 - (TN) UCH VASCULAR ACCESS ASC LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35211 | $2732.00 | 1457465403 - VENTURE AMBULATORY SURGERY CENTER | 743257508 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35211 | $2377.00 | 1215990247 - SOUTHERN HILLS SURGERY CENTER LP, SOUTHERN HILLS SURGERY CENTER | 200533890 | TN | 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 35211 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 35211 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 35211 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 35211. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 35211 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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