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 |
National average reimbursement for CPT 35694 by major payers:
$1,376.09
$1,410.53
$1,460.68
$1,636.21
| 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 35694 | ||||||
United | 35694 | $564.00 | 1720024284 - PMA SURGERY CENTER, LLC | 721550480 - (TN) PMA SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35694 | $560.00 | 1083030597 - TRIAD SURGERY CENTER, LLC, TRIAD EYE INSTITUTE | 465002052 - (OK) TRIAD EYE INSTITUTE, PLLC | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35694 | $9383.00 | 1619008554 - CHARLES COLE MEMORIAL D/B/A UPMC COLE, SHORT PROCEDURE UNIT | 240802108 - UPMC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35694 | $904.00 | 1528762671 - BOULEVARD ENT SURGERY CENTER LLC | 921460644 - (TN) BOULEVARD ENT SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35694 | $850.00 | 1821036534 - PARKWAY SURGERY CENTER, LLC | 204127100 - (MD) PARKWAY SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35694 | $100.00 | 1700974995 - THE NEW JERSEY CENTER FOR EAR, NOSE AND THROAT DISORDERS, P.C. | 202822342 - (NJ) THE NEW JERSEY CENTER FOR EAR NOSE AND THROAT DISORDERS PC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35694 | $6068.00 | 1588190904 - TEXAS HEALTH HUGULEY SURGERY CENTER, LLC | 821289045 - (TX) TEXAS HEALTH HUGULEY SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35694 | $750.00 | 1003116823 - NORTHERN N.J. ENDOSCOPY CENTER, L.L.C. | 640955113 - (NJ) NORTHERN NJ ENDOSCOPY CENTER LLC | NJ | 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 | $750.00 | 1851865828 - ATLANTA SURGERY NORTH | 832134639 - (GA) ATLANTA SURGERY NORTH | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35694 | $500.00 | 1265816003 - CLEARVIEW SURGERY CENTER, LLC | 474123527 - (ID) CLEARVIEW SURGERY CENTER LLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35694 | $1000.00 | 1427585280 - PINNACLE SURGERY CENTER, INC | 812354493 - (CA) PINNACLE SURGERY CENTER INC | CA | 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 | $1100.00 | 1861458507 - BRASS PARTNERSHIP IN COMMENDAM | 721097827 - (LA) BRASS PARTNERSHIP IN COMMENDAM | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35694 | $6068.00 | 1245768209 - TEXAS HEALTH SURGERY CENTER BEDFORD, LLC, TEXAS HEALTH SURGERY CENTER BEDFORD | 821307876 - (TX) TEXAS HEALTH SURGERY CENTER BEDFORD LLC | 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 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 | Transposition And/Or Reimplantation; Vertebral To Subclavian Artery |
| 35694-CPT | High | Transposition And/Or Reimplantation; Subclavian To Carotid Artery |
| 35695-CPT | High | Transposition And/Or Reimplantation; Carotid To Subclavian Artery |
| 35701-CPT | Moderate | Exploration Not Followed By Surgical Repair Artery; Neck (Eg Carotid Subclavian) (Desc Rvsd 1/1/20) |
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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