CPT 35800 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-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 • 78 - Return to OR - related procedure • GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 35800 |
National average reimbursement for CPT 35800 by major payers:
$908.74
$907.96
$1,018.86
$1,144.06
| 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 35800 | ||||||
United | 35800 | $4650.00 | 1366181778 - AXION SPINE OUTPATIENT SURGERY CENTER | 881709019 - (GA) AXION SPINE OUTPATIENT SURGERY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35800 | $3760.00 | 1144815770 - GIULIO G DIAMANTE MD INC, SURGIHEALTH RHODE ISLAND | 50498699 - (RI) GIULIO G. DIAMANTE, MD, INC. | RI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35800 | $2463.00 | 1346244845 - LAKELAND SURGICAL & DIAGNOSTIC CENTER LLP | 934728316 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35800 | $4865.00 | 1548322829 - GASTROINTESTINAL MEDICAL CENTER | 954373071 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35800 | $2058.00 | 1982676227 - THE PALMETTO ASC, LLC, THE PALMETTO SURGERY CENTER | 621647406 - (FL) THE PALMETTO SURGERY CENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35800 | $1391.00 | 1376774208 - DIGESTIVE DISEASES DIAGNOSTIC & TREATMENT CENTER LLC | 261319443 - (NY) DIGESTIVE DISEASES DIAGNOSTIC TREATMENT CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35800 | $680.00 | 1295847317 - DIGESTIVE HEALTH & ENDOSCOPY CENTER LLC | 204370189 | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35800 | $2472.00 | 1528130879 - PACIFIC SURGICAL INSTITUTE OF PAIN MANAGEMENT | 330776873 - (CA) PACIFIC SURGICAL INSTITUTE OF PAIN MANAGEMENT | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35800 | $6492.00 | 1467601625 - MNH GI SURGICAL CENTER LLC, MNH SURGICAL CENTER | 263094275 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35800 | $3801.00 | 1740787068 - CLEVELAND CLINIC FLORIDA (A NONPROFIT CORPORATION), CLEVELAND CLINIC FLORIDA CORAL SPRINGS ASC | 650003177 - CLEVELAND CLINIC FLORIDA A NONPROFIT CORPORATION | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35800 | $4414.00 | 1558983833 - TRIAD CENTER FOR SURGERY, KIMEL PARK SURGERY CENTER | 844248237 - (NC) TRIAD CENTER FOR SURGERY LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35800 | $875.00 | 1932207669 - EYE SURGICAL CENTER OF MISSISSIPPI | 200669972 - (MS) EYE SURGICAL CENTER OF MISSISSIPPI | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35800 | $2036.00 | 1619124401 - CHARLOTTE GASTROENTEROLOGY & HEPATOLOGY, PLLC | 562059693 - (NC) CHARLOTTE GASTROENTEROLOGY & HEPATOLOGY, PLLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35800 | $1765.00 | 1285603100 - MEMPHIS EYE AND CATARACT AMBULATORY SURGERY CENTER INC, MECA LASER AND SURGERY CENTER | 621244331 - (TN) MEMPHIS EYE AND CATARACT AMBULATORY SURGERY CENTER INC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35800 | $5846.00 | 1962938332 - BANNER UNION HILLS SURGERY CENTER LLC | 901164193 - (AZ) BANNER UNION HILLS SURGERY CENTER LLC | AZ | 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 35800 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 35800 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 35800 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 |
|---|---|---|
| 35700-CPT | Moderate | Reoperation, Femoral-Popliteal Or Femoral (Popliteal)-Anterior Tibial, Posterior Tibial, Peroneal Artery, Or Other Distal Vessels, More Than 1 Month After Original Operation (List Separately In Addition To Code For Primary Procedure) |
| 35800-CPT | Moderate | Expl.Pstop Hemm.;Throm/Infect;Neck |
| 35820-CPT | High | Explor Postop Hemorr/Thrombus Chest |
| 35840-CPT | High | Explor-Post-Op Hemorrhg/Thromb;Abd |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 35800. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 35800 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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