CPT 35537 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 | • 59 - Distinct Procedural Service • LT - Left side of body • 82 - Assistant surgeon - no qualified resident |
| Complexity Level | High |
National average reimbursement for CPT 35537 by major payers:

$2,625.64

$2,964.41

$3,039.32

$3,451.61
| 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 35537 | ||||||
United | 35537 | $553.00 | 1508810656 - RETINAL AMBULATORY SURGERY CENTER OF NEW YORK, INC. | 134189700 - (NY) RETINAL AMBULATORY SURGERY CENTER OF NY, INC. | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35537 | $550.00 | 1184680407 - OAK BROOK SURGICAL CENTRE INC. | 363317971 - (IL) OAKBROOK SURGICAL CENTRE, INC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35537 | $990.00 | 1154034429 - CROSSINGS SURGERY CENTER, LLC | 881346867 - (RI) CROSSINGS SURGERY CENTER LLC | RI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35537 | $475.00 | 1942956123 - METROLINA VASCULAR ACCESS CARE LLC | 831967528 - (NC) METROLINA VASCULAR ACCESS CARE LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35537 | $17689.00 | 1174969372 - AURORA GI ASC LLC, WISCONSIN DIGESTIVE HEALTH CENTER | 461848055 - (WI) AURORA GI ASC LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35537 | $95.00 | 1700822335 - OLIVER STREET DERMATOLOGY ASC LLC, DERMATOLOGY SURGERY CENTER | 461320839 - (TX) OLIVER STREET DERMATOLOGY ASC LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35537 | $607.00 | 1831746007 - GC SURGERY CENTER LLC | 823013393 - (GA) GC SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35537 | $500.00 | 1932298718 - OUTPATIENT SERVICES EAST | 630888861 - (AL) OUTPATIENT SERVICES EAST LTD | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35537 | $1306.00 | 1932164852 - MAY STREET SURGI CENTER, LLC, MAY STREET SURGI CENTER | 223777533 - (NJ) MAY STREET SURGI CENTER, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35537 | $370.00 | 1225579485 - SUNRISE SKIN CANCER SURGERY CENTER, LLC | 462596462 - (AL) SUNRISE SKIN CANCER SURGERY CENTER LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35537 | $1064.00 | 1184671760 - CHANDLER ENDOSCOPY CENTER, L.L.C. | 454307241 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35537 | $469.00 | 1972556942 - CHERRY HILL WOMEN'S CENTER, INC. | 232068660 - (NJ) CHERRY HILL WOMENS CENTER INC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35537 | $472.00 | 1972541415 - OCEAN ENDOSURGERY CENTER LLC, OCEAN ENDOSURGERY CENTER | 223564617 - (NJ) OCEAN ENDOSURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35537 | $1028.00 | 1326142878 - LEBANON ENDOSCOPY CENTER LLC, LEBANON ENDOSCOPY CENTER | 205449574 - (TN) LEBANON ENDOSCOPY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35537 | $259.00 | 1548582463 - CAREPLEX ORTHOPAEDIC AMBULATORY SURGERY CENTER, LLC, NONE | 271867311 - (VA) CAREPLEX ORTHOPAEDIC AMBULATORY SURGERY CENTER LLC | VA | 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 35537 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 35537 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 35537 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 35537. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 35537 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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