CPT 35694 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 11 - Office |
| Common Modifiers | None LT - Left side of body RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 35694 |
| Medicaid Fee Schedule | View Medicaid rates for 35694 |
National average reimbursement for CPT 35694 by major payers:
$1,376.09
$1,410.53
$1,460.68
$1,601.23
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 35694 | $468.00 | 1922075969 - SAINT MARY'S AMBULATORY SURGERY | 550837980 - (NJ) SAINT MARYS AMBULATORY SURGERY | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35694 | $8891.00 | 1013493824 - ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO, LURIE CHILDREN'S SURGERY CENTER IN NORTHBROOK | 362170833 - ANN & ROBERT H LURIE CHILDRENS HOSPITAL OF CHICAGO | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35694 | $736.00 | 1750568838 - VIVERE HEALTH DALLAS, LLC, VIVERE-DALLAS SURGERY CENTER | 364701304 - (TX) VIVERE HEALTH DALLAS LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35694 | $1056.00 | 1578534459 - BOSTON OUT-PATIENT SURGICAL SUITES, LLC | 270050256 - (MA) BOSTON OUT-PATIENT SURGICAL SUITES, LLC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35694 | $1100.00 | 1861458507 - BRASS PARTNERSHIP IN COMMENDAM | 721097827 - (LA) BRASS PARTNERSHIP IN COMMENDAM | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35694 | $518.00 | 1952535502 - PLATEAU SURGERY CENTER | 264769256 - (TN) PLATEAU SURGERY CENTER | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35694 | $750.00 | 1700389822 - CENTER FOR SPINE INTERVENTIONS ASC 2 | 813634134 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35694 | $1124.00 | 1780109934 - BANNER MESA SURGERY CENTER LLC | 901182682 - (AZ) BANNER MESA SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35694 | $300.00 | 1184675704 - DOCTORS SURGERY CENTER LLC | 593518740 - (FL) DOCTORS SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35694 | $580.00 | 1326170036 - TAMPA BAY EYE SURGERY CENTER, LLC | 273286942 - (FL) TAMPA BAY EYE SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35694 | $1028.00 | 1659772648 - SURGICAL SPECIALTY CENTER OF MID ATLANTIC, LLC | 465727021 - (MD) SURGICAL SPECIALTY CENTER OF MID-ATLANTIC, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35694 | $2932.00 | 1952720674 - BOUNTIFUL SURGERY CENTER, LLC | 364581088 | UT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35694 | $524.00 | 1528039567 - PREMIER PROFESSIONAL SURGERY CENTER PC, PARKEYE SURGI CENTER | 381894684 - (MI) PARK EYE & SURGI CENTER | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35694 | $1064.00 | 1245427228 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35694 | $1306.00 | 1205929080 - OAK TREE SURGERY CENTER, LLC | 223524889 - (NJ) OAK TREE SURGERY CENTER, LL, LLC | NJ | 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 35694 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 35694 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 35694 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 |
|---|---|---|
| 35693-CPT | High | Surgery To Move Blood Vessel, Surgery To Move A Blood Vessel To Another Position In The Neck Upper Back Or Chest. The Procedure Is Done To Compensate For An Injury That Affects How Well Blood Flows. |
| 35694-CPT | High | Surgery To Move Blood Vessel, Surgery To Move A Blood Vessel To Another Position In The Neck Upper Back Or Chest. The Procedure Is Done To Compensate For An Injury That Affects How Well Blood Flows. |
| 35695-CPT | High | Surgery To Move Blood Vessel, Surgery To Move A Blood Vessel To Another Position In The Neck Upper Back Or Chest. The Procedure Is Done To Compensate For An Injury That Affects How Well Blood Flows. |
| 35701-CPT | Moderate | Exploration (Not Followed By S, Exploration (Not Followed By Surgical Repair) With Orwithout Lysis Of Artery Carotid Artery |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 35694. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 35694 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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