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CPT 35256 Fee Schedule

Last Verified: March 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 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
Medicare Fee ScheduleView Medicare rates for 35256

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$4704.001336459353 - LONE STAR ENDOSCOPY CENTER LLC273635726TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
35256$4677.001437155207 - TEXARKANA SURGERY CENTER LP752807190 - (TX) TEXARKANA SURGERY CENTER LPTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
35256$6087.001912933680 - SOUTHWESTERN AMBULATORY SURGERY CENTER, LLC562422009 - (PA) SOUTHWESTERN AMBULATORY SURGERY CENTERPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
35256$8087.001518344043 - MEMORIAL HERMANN SURGERY CENTER KIRBY, LLC, MEMORIAL HERMANN SURGERY CENTER KIRBY GLEN364801162TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
35256$6000.001194264036 - ADVANCED SURGICAL CENTER, LLC475144859 - (TX) ADVANCED SURGICAL CENTER LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
35256$6365.001942507488 - GA ENDOSCOPY CENTER, LLC273115800 - (GA) GA ENDOSCOPY CENTER LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
35256$847.001720833163 - MIDWEST EYE CENTER363010536 - (IL) MIDWEST EYE CENTERILAmbulatory Surgical Clinic/Center (261QA1903X)
United
35256$6588.001841626090 - COLUMBUS ENDOSCOPY CENTER LLC463368948GAAmbulatory Surgical Clinic/Center (261QA1903X)
United
35256$5797.001750499950 - MEDPLEX OUTPATIENT SURGERY CENTER LTD, MEDPLEX OUTPATIENT SURGERY CENTER760353620 - (AL) MEDPLEX OUTPATIENT SURGERY CENTER LTDALAmbulatory Surgical Clinic/Center (261QA1903X)
United
35256$1472.001043239338 - NORTH VALLEY ENDOSCOPY CENTER LLC201729172 - (AZ) NORTH VALLEY ENDOSCOPY CENTER LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
35256$6492.001942472931 - SURGCENTER OF GLEN BURNIE, SURGCENTER OF GLEN BURNIE, LLC261572774 - (MD) SURGCENTER OF GLEN BURNIE, LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
35256$3836.001043690845 - UNION HILLS PAIN PARTNERS LLC, HONORHEALTH PAIN MANAGEMENT CENTER473325492 - (AZ) UNION HILLS PAIN PARTNERS LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
35256$3811.001548226442 - ARTHROSCOPIC & LASER SURGERY CENTER OF SAN DIEGO LP631166884 - (CA) ARTHROSCOPIC & LASER SURGERY CENTER OF SAN DIEGO, LPCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
35256$1550.001689059222 - GOLDSTEP AMBULATORY SURGERY CENTER, LLC465647464 - (NY) GOLDSTEP AMBULATORY SURGERY CENTER LLCNYAmbulatory Surgical Clinic/Center (261QA1903X)
United
35256$2701.001760770903 - ASSOCIATED SURGICAL CENTER OF DEARBORN LLC275209399 - (MI) ASSOCIATED SURGICAL CENTER OF DEARBORN LLCMIAmbulatory 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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