CPT 36012 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 | • 11 - Office • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 36012 |
National average reimbursement for CPT 36012 by major payers:
$953.70
$1,142.76
$1,280.84
$1,312.01
| 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 36012 | ||||||
United | 36012 | $258.00 | 1689843963 - PAIN-MDS AMBULATORY SURGICAL CENTER, LLC | 261980849 - (AZ) PAINMDS AMBULATORY SURGICAL CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36012 | $2100.00 | 1871519314 - NORTHERN LITHO INC | 161511455 - (FL) NORTHERN LITHO, INC. | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36012 | $1344.00 | 1932164852 - MAY STREET SURGI CENTER, LLC, MAY STREET SURGI CENTER | 223777533 - (NJ) MAY STREET SURGI CENTER, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36012 | $1665.00 | 1346235058 - EAST MEQUON SURGERY CENTER LLC | 861075286 - (WI) EAST MEQUON SURGERY CENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36012 | $790.00 | 1609400290 - ORTHOPAEDIC ASSOCIATES OF CENTRAL TEXAS SURGERY CENTER, LLC | 844818321 - (TX) ORTHOPAEDIC ASSOCIATES OF CENTRAL TEXAS SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36012 | $113.00 | 1508911728 - MINIMALLY INVASIVE SURGICAL AND NEUROSCIENCE LLC, DELAWARE OUTPATIENT CENTER FOR SURGERY | 161694674 - (DE) DELAWARE OUTPATIENT CENTER FOR SURGERY | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36012 | $1501.03 | 1629125679 - OLUBUNMI ADEGBOYEGA | 350593390 - DEACONESS HOSPITAL INC | KY | Hospitalist Physician (208M00000X) |
United | 36012 | $1145.00 | 1003842626 - AMBULATORY CENTER FOR ENDOSCOPY, LLC | 200064962 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36012 | $88.00 | 1063437994 - TRI-CITIES ENDOSCOPY CENTER PC, THE CENTER FOR DIGESTIVE WELLNESS | 621867929 - (TN) TRICITIES ENDOSCOPY CENTER PC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36012 | $180.00 | 1306589809 - CCRM FLORIDA LLC, CCRM FLORIDA | 873211160 - (FL) CCRM FLORIDA LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36012 | $112.00 | 1639290026 - JOHNS HOPKINS SURGERY CENTERS SERIES | 208707724 - (MD) JOHNS HOPKINS SURGERY CENTER SERIES | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36012 | $1501.03 | 1801091269 - MICHELLE HAUCK | 350593390 - DEACONESS HOSPITAL INC | WI | Internal Medicine Physician (207R00000X) |
United | 36012 | $1501.03 | 1730612599 - MOLLY FLOTTMAN | 350593390 - DEACONESS HOSPITAL INC | IN | Pediatric Critical Care Medicine Physician (2080P0203X) |
United | 36012 | $190.00 | 1568981975 - WEST MICHIGAN SURGICAL CENTER, LLC | 820593284 - (MI) WEST MICHIGAN SURGICAL CENTER, L | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36012 | $75.00 | 1841304797 - SOUTH GEORGIA ENDOSCOPY CENTER, INC | 593737668 - (GA) SOUTH GEORGIA ENDOSCOPY CENTER INC | GA | 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 36012 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 36012 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 36012 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 |
|---|---|---|
| 36010-CPT | Moderate | Introduction Of Catheter; In Superior Or Inferior Vena Cava, Right Heart Or Pulmonary Artery |
| 36011-CPT | Moderate | Select Cath Plcmt Venous; First Order Br |
| 36012-CPT | Moderate | Selective Catheter Placement, Venous System; Second Order, Or More Selective, Branch (Eg, Left Adrenal Vein, Petrosal Sinus) |
| 36013-CPT | Moderate | Intro Cath Rt Heartor Main Pulmonary Ar |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 36012. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 36012 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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