CPT 35251 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 • 82 - Assistant surgeon - no qualified resident • 51 - Multiple procedures |
| Complexity Level | High |
National average reimbursement for CPT 35251 by major payers:

$2,387.92

$2,385.00

$2,540.05

$2,812.37
| 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 35251 | ||||||
United | 35251 | $400.00 | 1194718940 - 20-20 SURGERY CENTER LLC | 331066427 - (PA) 2020 SURGERY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35251 | $229.00 | 1336185230 - Q CORP SURGERY CENTER INC, AFP SURGERY CENTER | 204910974 - (PA) Q CORP SURGERY CENTER INC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35251 | $373.00 | 1922055235 - SEIDENBERG PROTZKO SURGERY CENTER LLC, MID ATLANTIC SURGERY PAVILION | 203363768 - (MD) SEIDENBERG PROTZKO SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35251 | $983.00 | 1922510643 - OPTIMUM SPINE CENTER, LLC, PEACHTREE SPINE & PAIN PHYSICIANS | 320543789 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35251 | $588.00 | 1770837866 - SPINE AND PAIN PHYSICIANS SURGERY CENTER, LLC | 454831116 - (TN) SPINE AND PAIN PHYSICIANS SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35251 | $266.00 | 1821336371 - EYECARE SURGERY CENTER, LLC | 461073660 - (MS) EYECARE SURGERY CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35251 | $100.00 | 1285120352 - AKDHC SURGERY CENTER, LLC | 753052504 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35251 | $353.00 | 1598700676 - FLORIDA EYE INSTITUTE SURGICENTER LLC | 134232690 - (FL) FLORIDA EYE INSTITUTE SURGICENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35251 | $509.00 | 1639498579 - INTERVENTIONAL SPINE CENTER, LLC | 263161503 - (CA) INTERVENTIONAL SPINE CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35251 | $401.00 | 1235285628 - DAYTON EYE SURGERY CENTER L.L.C., DAYTON EYE SURGERY CENTER | 311596557 - (OH) DAYTON EYE SURGERY CENTER | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35251 | $750.00 | 1194255372 - DECATUR UROLOGY SURGERY CENTER | 814721108 - (GA) DECATUR UROLOGY SURGERY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35251 | $530.00 | 1861470486 - ORLAND PARK SURGICAL CENTER LLC | 364418271 - (IL) ORLAND PARK SURGICAL CENTER, LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35251 | $545.00 | 1225077241 - CORTEZ FOOT SURGERY CENTER, P.A. | 650064196 - (FL) CORTEZ FOOT SURGERY CENTER PA | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35251 | $724.00 | 1497727119 - DIGESTIVE ENDOSCOPY CENTER LLC, DIGESTIVE ENDOSCOPY CENTER | 311508446 - (OH) DIGESTIVE ENDOSCOPY CENTER, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35251 | $658.00 | 1174850176 - SOUTHWEST OHIO PAIN MANAGEMENT LLC | 300571536 - (OH) SOUTHWEST OHIO PAIN MANAGEMENT | OH | 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 35251 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 35251 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 35251 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 35251. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 35251 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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