CPT 35509 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 |
| Common Modifiers | • None • 82 - Assistant surgeon - no qualified resident • RT - Right side of body • 78 - Return to OR - related procedure • GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 35509 |
National average reimbursement for CPT 35509 by major payers:
$1,831.82
$1,965.21
$2,036.85
$2,288.70
| 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 35509 | ||||||
United | 35509 | $425.00 | 1871593269 - ACADIANA SURGERY CENTER, INC. | 721235496 - (LA) ACADIANA SURGERY CENTER INC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35509 | $973.00 | 1902895675 - CAROMONT HEALTH SERVICES, INC., CAROMONT SPECIALTY SURGERY | 561455630 - (NC) CAROMONT HEALTH SERVICES INC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35509 | $642.00 | 1578610564 - HOLDINGS OF SPINECARE, LLC, SPINECARE LLP | 200950730 - (TX) HOLDINGS OF SPINECARE LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35509 | $1064.00 | 1629508387 - WELLINGTON ENDOSCOPY CENTER LLC | 813254698 - (FL) WELLINGTON ENDOSCOPY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35509 | $1234.00 | 1942230024 - LUTHERVILLE ENDOSCOPY CENTER LLC | 823193901 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35509 | $825.00 | 1992759930 - IDAHO SURGICENTER INC, IDAHO SURGICENTER SOUTH | 200049792 - (ID) IDAHO SURGICENTER INC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35509 | $435.00 | 1265494553 - CORAL VIEW SURGERY CENTER, LLC | 650708055 - (FL) CORAL VIEW SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35509 | $2732.00 | 1427012202 - OUTPATIENT SURGICAL SERVICES LTD | 752433596 - (FL) OUTPATIENT SURGICAL SERVICES LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35509 | $364.00 | 1417190935 - MID-FLORIDA ENDOSCOPY & SURGERY CENTER LLC | 263388221 - (FL) MID-FLORIDA ENDOSCOPY & SURGER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35509 | $5667.00 | 1053391870 - NORTHWEST SURGERY CENTER, LTD, NORTHWEST SURGERY CENTER RED OAK | 760452319 - (TX) NORTHWEST SURGERY CENTER LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35509 | $12881.00 | 1710201538 - DUBLIN SURGERY CENTER LLC | 272103713 | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35509 | $408.00 | 1821067554 - OLD TOWN ENDOSCOPY CENTER LLC, DIGESTIVE HEALTH CENTER OF DALLAS | 752774028 - (TX) OLD TOWN ENDOSCOPY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35509 | $400.00 | 1508896705 - TIFTAREA ENDOSCOPY CENTER, INC. | 582394224 - (GA) TIFTAREA ENDOSCOPY CENTER INC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35509 | $758.00 | 1336635747 - ROCKVILLE SURGICAL SUITES, LLC | 825263227 - (MD) ROCKVILLE SURGICAL SUITES LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35509 | $147.00 | 1770753998 - SKIN CANCER TREATMENT CENTER, L.L.C. | 262051034 - (MD) SKIN CANCER TREATMENT CENTER LLC | MD | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 35509 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 35509 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 35509 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 |
|---|---|---|
| 35390-CPT | Moderate | Reoperation, Carotid, Thromboendarterectomy, More Than 1 Month After Original Operation (List Separately In Addition To Code For Primary Procedure) |
| 35501-CPT | High | Bypass Graft, W/Vein; Carotid |
| 35508-CPT | High | Bypass Graft W Vein; Carotid-Vertebral |
| 35509-CPT | High | Bypass Gft,W/Vein;Carotid-Carotid |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 35509. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 35509 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 35509) and we'll show you how you compare in 15 minutes or less.