CPT 35876 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 • 78 - Return to OR - related procedure • RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 35876 |
National average reimbursement for CPT 35876 by major payers:
$1,316.72
$1,329.91
$1,400.54
$1,553.33
| 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 35876 | ||||||
United | 35876 | $5595.00 | 1104907328 - ANDREWS INSTITUTE ASC LLC | 352274952 - (FL) ANDREWS INSTITUTE ASC, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35876 | $4914.00 | 1669748125 - RIVERVIEW SURGERY CENTER LLC | 452951941 - (IN) RIVERVIEW SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35876 | $2410.00 | 1225286354 - ASC DEVELOPMENT COMPANY, LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35876 | $3037.00 | 1649317660 - ORTHOVIRGINIA, INC | 540885859 - (VA) ORTHOVIRGINIA, INC. | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35876 | $6365.00 | 1952814386 - ADVANCED SURGICAL CARE OF BOERNE, LLC | 821680961 - (TX) ADVANCED SURGICAL CARE OF BOERNE LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35876 | $2101.00 | 1033282173 - TEMECULA VALLEY DAY SURGERY & PAIN THERAPY CENTER, INC. | 330469645 - (CA) TEMECULA VALLEY DAY SURGERY PAIN THERAPY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35876 | $7888.00 | 1841605318 - FLORIDA ORTHOPAEDIC INSTITUTE SURGERY CENTER, LLC, FLORIDA ORTHOPAEDIC INSTITUTE SURGERY CENTER-CITRUS PARK | 593646134 - (FL) FLORIDA ORTHOPAEDIC INSTITUTE SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35876 | $1588.00 | 1487059002 - RIVERWALK ASC, LLC, RIVERWALK ASC | 472075991 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35876 | $6721.00 | 1417912098 - BAILEY SQUARE AMBULATORY SURGICAL CENTER, LTD | 752467365 - (TX) BAILEY SQUARE AMBULATORY SURGICAL CENTER LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35876 | $6492.00 | 1104485440 - SURGCENTER OF GREATER JACKSONVILLE, LLC | 832504492 - (FL) SURGCENTER OF GREATER JACKSONVILLE LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35876 | $6492.00 | 1891257473 - WESTGATE SURGERY CENTER, LLC, WESTGATE SURGERY CENTER | 352651945 - (AZ) WESTGATE SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35876 | $3580.00 | 1679010417 - PIVAC ASC LLC | 814840875 - (CA) PIVAC ASC LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35876 | $6588.00 | 1568967131 - CENTRAL MAINE EYE SURGERY CENTER LLC | 824811437 - (ME) CENTRAL MAINE EYE SURGERY CENTER LLC | ME | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35876 | $1372.00 | 1073888103 - SURGERY BY VOLD VISION | 454504788 - (AR) SURGERY BY VOLD VISION | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35876 | $4234.00 | 1386882587 - BAYLOR SURGICARE AT GRANBURY LLC, BAYLOR SCOTT & WHITE SURGICARE-GRANBURY | 263896477 | 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 35876 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 35876 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 35876 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 |
|---|---|---|
| 35682-CPT | Moderate | Bypass Graft; Autogenous Composite Two Segments Of Veins From Two Locations (List Separately In Addition To Code For Primary Procedure) |
| 35703-CPT | Moderate | Exploration Not Followed By Surgical Repair Artery; Lower Extremity (Eg Common Femoral Deep Femoral Superficial Femoral Popliteal Tibial Peroneal) |
| 35875-CPT | Moderate | Thrombectomy/Repair Of Arterialor Venou |
| 35876-CPT | High | Thrombectomy Of Arterial Or Venous Graft (Other Than Hemodialysis Graft Or Fistula); With Revision Of Arterial Or Venous Graft |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 35876. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 35876 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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