CPT 35539 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 | • RT - Right side of body • None • LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 35539 |
National average reimbursement for CPT 35539 by major payers:
$2,844.37
$3,084.83
$3,147.33
$3,595.71
| 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 35539 | ||||||
United | 35539 | $1056.00 | 1588801377 - CHILDREN'S NORTH SURGERY CENTER, LLC | 262394578 - (CO) CHILDRENS HOSPITAL NORTH SURGE | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35539 | $734.00 | 1366868572 - PREMIER SURGERY CENTER, LLC | 463321793 - (NC) PREMIER SURGERY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35539 | $1971.00 | 1093079196 - MERCY HOSPITALS EAST COMMUNITIES, MERCY OUTPATIENTSURGERY CENTER WASHINGTON | 431066883 - (MO) MERCY HOSPITALS EAST COMMUNITIES | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35539 | $481.00 | 1063715951 - NEW BRITAIN SURGERY CENTER LLC | 273829147 - (PA) NEW BRITAIN SURGERY CENTER, LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35539 | $998.00 | 1881089076 - FREEMAN SURGICAL CENTER OF PITTSBURG, LLC | 473537670 | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35539 | $7840.00 | 1740562677 - LOWCOUNTRY SURGERY CENTER LLC, ROPER ST FRANCIS EYE CENTER | 581693021 - (SC) LOWCOUNTRY SURGERY CENTER | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35539 | $996.00 | 1265009005 - SURGCENTER NORTHERN PHOENIX LLC | 854160690 - (AZ) SURGCENTER NORTHERN PHOENIX LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35539 | $250.00 | 1164495198 - SARASOTA OPHTHALMOLOGY ASC LLC, CENTER FOR ADVANCED EYE SURGERY | 621825704 - (FL) SARASOTA OPHTHALMOLOGY ASC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35539 | $200.00 | 1215038252 - RED LION SURGICENTER, LLC | 204914143 - (PA) RED LION SURGICENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35539 | $600.00 | 1184689408 - EVERGREEN EYE CENTER, PLLC, EYE ASSOCIATES NORTHWEST SURGERY CENTER | 911610832 - (WA) EYE ASSOCIATES NORTHWEST, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35539 | $746.00 | 1346331329 - PHYSICIANS EYE SURGERY CENTER LLC, PHYSICIANS' EYE SURGERY CENTER | 571116347 - (SC) PHYSICIANS EYE SURGERY CENTER | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35539 | $1075.00 | 1427144336 - PORTLAND CLINIC, THE PORTLAND CLINIC SURGICAL CENTER | 930400952 - (OR) THE PORTLAND CLINIC LLP | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35539 | $360.00 | 1508840893 - PARKWAY SURGERY CENTER | 621799370 - (SC) PARKWAY SURGERY CENTER, LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35539 | $1028.00 | 1396342481 - PIEDMONT ASC LLC | 851448653 | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35539 | $1274.00 | 1518984301 - ENDOSCOPY CENTER OF INLAND EMPIRE INC | 474733900 | CA | 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 35539 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 35539 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 35539 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 35539. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 35539 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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