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See a sample rate comparisonCPT 35860 Fee Schedule
Last Verified: October 2026
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.
Exploratory Surgery, Exploratory Surgery To Examine A Site For Possible Hemorrhage (Excessive Bleeding) Or Infection Complications Following The Initial Surgery.
| 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 | 78 - Return to OR - related procedure RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $775.57 national non-facility rate (2026) · View Medicare rates for 35860 |
| Medicaid Fee Schedule | $600.615 median of the 8 states in the free preview · View Medicaid rates for 35860 |
National average reimbursement for CPT 35860 by major payers:
$985.15
$1,005.70
$1,124.09
$1,230.51
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CPT 35860
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center Sugar Land LLP
$7,838.00Published rateSouth Jersey Musculoskeletal Institute, LLC, Advanced Surgical Institute
South Jersey Musculoskeletal Institute, LLC
$3,350.00Published rateKy Advanced Surgical Center Inc
$1,800.00Published rateMadison Avenue Surgery Center LLC
$1,400.00Published rateCynthia Gress
Deaconess Hospital Inc
$662.63Published rate
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See a sample payer proposalCPT 35860 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 35860 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 35860 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 |
|---|---|---|
| 35702-CPT | Moderate | Exploration Not Followed By Su, Exploration Not Followed By Surgical Repair Artery Upper Extremity (Eg Axillary Brachial Radial Ulnar) |
| 35840-CPT | High | Exploratory Surgery, Exploratory Surgery To Examine A Site For Possible Hemorrhage (Excessive Bleeding) Or Infection Complications Following The Initial Surgery. |
| 35860-CPT | Moderate | Exploratory Surgery, Exploratory Surgery To Examine A Site For Possible Hemorrhage (Excessive Bleeding) Or Infection Complications Following The Initial Surgery. |
| 35870-CPT | High | Repair Of Graft Complication, Surgery To Repair A Passageway (Fistula) That Has Developed Between A Blood Vessel Graft And Some Portion Of The Intestinal Area. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 35860. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 35860 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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