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See a sample rate comparisonCPT 35616 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.
Artery Bypass With Graft, Surgery To Bypass (Re-Route) Blood Flow Around A Blocked Artery Using A Synthetic Material (Graft) To Replace The Diseased Artery.
| 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 LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | $1,002.70 national non-facility rate (2026) · View Medicare rates for 35616 |
| Medicaid Fee Schedule | $857.41 median of the 8 states in the free preview · View Medicaid rates for 35616 |
National average reimbursement for CPT 35616 by major payers:
$1,473.80
$1,534.60
$1,572.32
$1,753.21
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CPT 35616
5 of 25 sample ratesHigher to lower in this preview
Endoscopy Center Of Ocean County, LLC
Endoscopy Center Of Ocean County, PC
$1,306.00Published ratePalm Beach International Surgery Center LLC, Palm Beach International Surgery Center At The Paley Institute
Palm Beach International Surgery Center LLC
$1,049.00Published rateScottsdale Surgical Partners LLC, North Valley Surgery Center
$743.00Published rateCardiovascular Institute Of The South Asc, LLC
Cardiovascular Institute Of The South Asc LLC
$483.00Published rateHendi Ambulatory Surgery Center, PC
Hendi Ambulatory Surgery Center PC
$147.00Published rate
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See a sample payer proposalCPT 35616 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 35616 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 35616 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 |
|---|---|---|
| 35612-CPT | High | Artery Bypass With Graft, Surgery To Bypass (Re-Route) Blood Flow Around A Blocked Artery Using A Synthetic Material (Graft) To Replace The Diseased Artery. |
| 35616-CPT | High | Artery Bypass With Graft, Surgery To Bypass (Re-Route) Blood Flow Around A Blocked Artery Using A Synthetic Material (Graft) To Replace The Diseased Artery. |
| 35621-CPT | High | Artery Bypass With Graft, Surgery To Bypass (Re-Route) Blood Flow Around A Blocked Artery Using A Synthetic Material (Graft) To Replace The Diseased Artery. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 35616. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 35616 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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