CPT 35903 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 LT - Left side of body 78 - Return to OR - related procedure |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 35903 |
| Medicaid Fee Schedule | View Medicaid rates for 35903 |
National average reimbursement for CPT 35903 by major payers:
$760.12
$798.64
$851.93
$922.21
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 35903 | $3156.00 | 1508965401 - MILLENNIUM SURGERY CENTER INC | 770513445 - (CA) MILLENNIUM SURGERY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35903 | $2250.00 | 1528480076 - SOUTH ATLANTA AMBULATORY SURGICAL CENTER, LLC | 462848445 - (GA) SOUTH ATLANTA AMBULATORY SURGICAL CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35903 | $2703.00 | 1770731853 - SHAWNEE MISSION PRAIRIE STAR SURGERY CENTER LLC, ADVENTHEALTH SURGERY CENTER LENEXA | 364634843 - (KS) SHAWNEE MISSION PRAIRIE STAR SURGERY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35903 | $1927.00 | 1437801388 - FRESENIUS ACCESS CARE PHYSICIANS OF MADISON ASC LLC | 863588248 - (WI) FRESENIUS ACCESS CARE PHYSICIANS OF MADISON ASC LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35903 | $1050.00 | 1316061765 - PUBLIC HOSPITAL DIST NO 1 SKAGIT | 562392010 | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35903 | $1399.00 | 1386618783 - LEWES DE ENDOSCOPY ASC LLC, SEASIDE ENDOSCOPY PAVILION | 562299727 - (DE) LEWES DE ENDOSCOPY ASC LLC | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35903 | $2637.00 | 1447949706 - BAPTIST HEALTH SURGERY CENTER, LLC, BAPTIST HEALTH SURGERY CENTER AT BOCA RATON RESEARCH PARK | 650663357 - (FL) BAPTIST HEALTH SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35903 | $6342.00 | 1104341254 - TEXAS HEALTH SURGERY CENTER ALLIANCE, LLC, TEXAS HEALTH SURGERY CENTER ALLIANCE | 822296081 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35903 | $2949.00 | 1770884140 - TRUCKEE SURGERY CENTER LLC | 273943102 - (CA) TRUCKEE SURGERY CENTER, LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35903 | $972.82 | 1487689014 - CLIFFORD DOTSON | 350593390 - DEACONESS HOSPITAL INC | IN | Hospitalist Physician (208M00000X) |
United | 35903 | $4243.00 | 1023070026 - TOMS RIVER SURGERY CENTER, LLC, TOMS RIVER SURGERY CENTER | 752854783 - (NJ) TOMS RIVER SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35903 | $3500.00 | 1538390539 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35903 | $972.82 | 1790766996 - JAMES LAGUARDIA | 350593390 - DEACONESS HOSPITAL INC | MO | Neurology Physician (2084N0400X) |
United | 35903 | $2855.00 | 1275158495 - BCC CHANDLER LLC | 851284830 - (AZ) BCC CHANDLER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 35903 | $2287.00 | 1881134815 - PORT JEFFERSON ASC, LLC | 371794376 - (NY) PORT JEFFERSON ASC LLC | NY | 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 35903 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 35903 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 35903 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 |
|---|---|---|
| 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. |
| 35697-CPT | Low | Reimplantation Visceral Arter, Reimplantation Visceral Artery To Infrarenal Aortic Prosthesis Each Artery (List Separately Inaddition To Code For Primary Procedure) |
| 35875-CPT | Moderate | Blood Clot Removal, Surgery To Remove A Blood Clot That Has Developed At Or Near The Site Of A Blood Vessel Graft. The Procedure Involves Repair Of The Graft Possibly Including Replacing It. |
| 35903-CPT | Moderate | Excision Of Infected Graft; Extremity |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 35903. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 35903 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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