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CPT 35256 Fee Schedule

Last Verified: December 2025

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 W Vein Graft Leg
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Cardiovascular System

Common Place of Service

21 - Inpatient Hospital

22 - On Campus Outpatient Hospital

Common Modifiers

None

RT - Right side of body

LT - Left side of body

Complexity LevelHigh

National average reimbursement for CPT 35256 by major payers:

bcbs

$1,386.99

uhc

$1,433.37

aetna

$1,489.72

cigna

$1,670.10

Preview provider-level rates for...
For billing codeCPT 35256
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 35256

United
35256$2895.001114924685 - SOUTH KANSAS CITY SURGICAL CENTER, LC, SOUTH KANSAS CITY SURGICENTER202181884 - (KS) SOUTH KANSAS CITY SURGICAL CENTER, LLCKSAmbulatory Surgical Clinic/Center (261QA1903X)
United
35256$980.001881875227 - SKIN & MOHS SURGERY CENTER, LLC431823843 - SKIN MOHS SURGERY CENTER LLCMOAmbulatory Surgical Clinic/Center (261QA1903X)
United
35256$2650.001124406632 - COMPREHENSIVE PAIN ASC, LLC473944400 - (CA) COMPREHENSIVE PAIN ASC LLCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
35256$800.001750313144 - AMBULATORY SURGICAL CARE, LLC593082994 - (FL) AMBULATORY SURGICAL CARE LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
35256$6588.001306843222 - ST. JOSEPH'S OUTPATIENT SURGERY CENTER, LLC562332449 - (AZ) ST JOSEPHS OUTPATIENT SURGERY CENTER LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
35256$1456.001265624696 - CENTRAL OHIO UROLOGY SURGERY CENTER, LLC261240704 - (OH) CENTRAL OHIO UROLOGY SURGERY CENTER LLCOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
35256$1172.001528032711 - COLUMBIA ENDOSCOPY CENTER, LLC710923725 - (MO) COLUMBIA ENDOSCOPY CENTER LLCMOAmbulatory Surgical Clinic/Center (261QA1903X)
United
35256$1083.001649957168 - BLUE ASH ENDOSCOPY CENTER, LLC931613837OHAmbulatory Surgical Clinic/Center (261QA1903X)
United
35256$2836.001346469731 - AKDHC SURGERY CENTER, LLC753052504AZAmbulatory Surgical Clinic/Center (261QA1903X)
United
35256$4069.001225123227 - COMPREHENSIVE PAIN MANAGEMENT CENTER, INC.770533953 - (CA) COMPREHENSIVE PAIN MANAGEMENT CENTER, INC.CAAmbulatory Surgical Clinic/Center (261QA1903X)
United
35256$5055.001508818634 - MONTEREY BAY ENDOSCOPY CENTER LLC770324855 - (CA) MONTEREY BAY ENDOSCOPY CENTER LLCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
35256$4240.001508500273 - GASTROINTESTINAL ASSOCIATES ENDOSCOPY CENTER, LLC262157335WIAmbulatory Surgical Clinic/Center (261QA1903X)
United
35256$3070.001518450790 - VIRGINIA ENT SURGERY CENTER INC541052755 - (VA) VIRGINIA EAR, NOSE & THROAT ASSOCIATES, P.C.VAAmbulatory Surgical Clinic/Center (261QA1903X)
United
35256$1752.001720388465 - WEST ASC, LLC, CAMILLUS SURGERY CENTER273166743 - (NY) WEST ASC, LLC DBA CAMILLUS SURGERY CENTERNYAmbulatory Surgical Clinic/Center (261QA1903X)
United
35256$2796.001720606932 - PHYSICIANS CLINIC INC470687317 - PHYSICIANS CLINIC INCNEAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 35256 vs. Other Surgical Procedures on the Cardiovascular System Codes

The CPT 35256 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 35256 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.

CodeComplexityDescription
35251-CPTHighRepair Blood Ves.W Graft; Intra-Abdomina
35256-CPTHighRep Vessel W Vein Graft Leg
35261-CPTHighRepair Blood Vessel W Graft Other Than V

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 35256. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 35256 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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