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See a sample rate comparisonCPT 35304 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.
Surgery For Blocked Artery, Surgery To Remove Plaque Or Clots From One Or More Arteries. The Procedure May Include Repairing A Damaged Blood Vessel With A Patch (Graft) From Another Blood Vessel.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Cardiovascular System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital 20 - Urgent Care Facility |
| Common Modifiers | RT - Right side of body LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | $1,155.67 national non-facility rate (2026) · View Medicare rates for 35304 |
| Medicaid Fee Schedule | $893.785 median of the 8 states in the free preview · View Medicaid rates for 35304 |
National average reimbursement for CPT 35304 by major payers:
$1,764.85
$1,780.41
$1,859.40
$2,048.55
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CPT 35304
5 of 25 sample ratesHigher to lower in this preview
East Mequon Surgery Center LLC
$16,050.00Published rateCherokee Farm Orthopedic Surgery Center, LLC
Cherokee Farm Orthopedic Surgery Center LLC
$1,100.00Published rateMiami Children'S Hospital Ambulatory Surgery Center, LLC
Miami Childrens Hospital Ambula
$840.00Published rateNovamed Surgery Center Of Colorado Springs, LLC, Premier Surgery Center
$583.00Published rateNorthern Illinois Surgery Center Limited Patrnership, The Center For Surgery
Northern Illinois Surgery Center Lp
$280.00Published rate
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See a sample payer proposalCPT 35304 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 35304 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 35304 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.
| Code | Complexity | Description |
|---|---|---|
| 35303-CPT | High | Surgery For Blocked Artery, Surgery To Remove Plaque Or Clots From One Or More Arteries. The Procedure May Include Repairing A Damaged Blood Vessel With A Patch (Graft) From Another Blood Vessel. |
| 35304-CPT | High | Surgery For Blocked Artery, Surgery To Remove Plaque Or Clots From One Or More Arteries. The Procedure May Include Repairing A Damaged Blood Vessel With A Patch (Graft) From Another Blood Vessel. |
| 35305-CPT | High | Surgery For Blocked Artery, Surgery To Remove Plaque Or Clots From One Or More Arteries. The Procedure May Include Repairing A Damaged Blood Vessel With A Patch (Graft) From Another Blood Vessel. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 35304. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 35304 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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