CPT 35638 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 | • None • 80 - Assistant surgeon • 62 - Co-Surgeons |
| Complexity Level | High |
National average reimbursement for CPT 35638 by major payers:
$2,191.20
$2,438.07
$2,556.54
$2,857.99
| 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 35638 | ||||||
United | 35638 | $732.00 | 1427005313 - WESTERN WASHINGTON MEDICAL GROUP, INC PS, WESTERN WASHINGTON MEDICAL GROUP ENDOSCOPY CENTER | 911602128 - (WA) WESTERN WASHINGTON MEDICAL GROUP, INC., P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35638 | $550.00 | 1598815110 - EXECUTIVE ENDOSCOPY, INC., ENDOSCOPY CENTER OF SAN JOSE | 770583401 - (CA) EXECUTIVE ENDOSCOPY INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35638 | $340.00 | 1629262274 - THE SURGERY CENTER OF THE VILLAGES, LLC, THE SURGERY CENTER OF THE VILLAGES | 208291654 - (FL) THE SURGERY CENTER OF THE VILLAGES LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35638 | $421.00 | 1639183486 - SAN JOAQUIN LASER SURGERY CENTER | 943308994 - (CA) SAN JOAQUIN LASER SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35638 | $1029.00 | 1497465249 - CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION, CONFLUENCE HEALTH MOSES LAKE ASC | 910171250 - CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35638 | $494.00 | 1073556338 - VALDOSTA PODIATRY ASSOCIATES, PC, NORTH OAK AMBULATORY SURGERY CENTER | 261479859 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35638 | $680.00 | 1053505511 - DIGESTIVE DISEASE CENTER OF CENTRAL NEW YORK, LLC | 260531425 - (NY) DIGESTIVE DISEASE CENTER OF CENTRAL NEW YORK LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35638 | $1049.00 | 1366982845 - JACKSONVILLE ENDOSCOPY CENTERS LLC, JACKSONVILLE CENTER FOR ENDOSCOPY | 384016302 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35638 | $1064.00 | 1063099190 - ASCENSION SAINT THOMAS LEBANON SURGERY CENTER LLC, LEBANON SURGERY CENTER | 862679471 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35638 | $1064.00 | 1194744532 - MOSES CONE MEDICAL SERVICES INC., LEBAUER ENDOSCOPY CENTER | 561714318 - MOSES CONE MEDICAL SERVICES INC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35638 | $2188.00 | 1568505899 - BON SECOURS SURGERY CENTER AT HARBOUR VIEW, LLC, BON SECOURS SURGERY CENTER AT HARBOUR VIEW | 208302537 - (VA) BON SECOURS SURGERY CENTER AT HARBOUR VIEW LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35638 | $1348.00 | 1770513855 - CAPITAL ENDOSCOPY LLC | 134244093 - (MD) CAPITAL ENDOSCOPY & SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35638 | $284.00 | 1982744231 - SOUTHLAND ENDOSCOPY CENTER, SOUTHLAND ENDOSCOPY CENTER | 330607952 - (CA) SOUTHLAND ENDOSCOPY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35638 | $1498.00 | 1790798668 - UNIVERSITY HOSPITALS MANAGEMENT SERVICES ORGANIZATION INC, UHHS WESTLAKE SURGERY CENTER | 341567805 - UNIVERSITY HOSPITALS HEALTH SYSTEM INC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35638 | $380.00 | 1164476933 - NOVAMED SURGERY CENTER OF SAN ANTONIO LP, AMERICAN SURGERY CENTER | 204400460 - (TX) NOVAMED SURGERY CENTER OF SAN ANTONIO LP | TX | 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 35638 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 35638 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 35638 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 35638. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 35638 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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