CPT 36013 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 • 24 - Ambulatory Surgical Center • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 51 - Multiple procedures • 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
National average reimbursement for CPT 36013 by major payers:
$870.15
$1,055.75
$1,138.04
$1,216.73
| 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 36013 | ||||||
United | 36013 | $170.00 | 1194959809 - BEVERLY HILLS REGIONAL SURGERY CENTER LP | 263718069 - (CA) BEVERLY HILLS REGIONAL SURGERY CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36013 | $210.00 | 1013468586 - LAKEWAY AMBULATORY SURGERY CENTER, LLC, LAKEWAY SURGERY CENTER | 383992761 - (TX) LAKEWAY AMBULATORY SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36013 | $182.00 | 1376518357 - ORLANDO FL ENDOSCOPY ASC LLC, CITRUS AMBULATORY SURGERY CENTER | 202873015 - ORLANDO FL ENDOSCOPY ASC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36013 | $406.00 | 1205454626 - EYE SURGERY CENTER OF WISCONSIN, LLC | 833779684 - (WI) EYE SURGERY CENTER OF WISCONSIN, LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36013 | $555.00 | 1144331760 - RESURGENS SURGERY CENTER LLC | 582397841 - (GA) RESURGENS SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36013 | $92.00 | 1932285111 - ORTHOVIRGINIA OPERATORY | 540885859 - (VA) ORTHOVIRGINIA, INC. | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36013 | $109.00 | 1013513308 - JOHN KENYON AMERICAN EYE INSTITUTE LLC, EYE SURGERY CENTER OF ELIZABETHTOWN | 351907389 - JOHN-KENYON AMERICAN EYE INSTITUTE | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36013 | $650.00 | 1730151168 - HAWTHORN PLACE OUTPATIENT SURGERY CENTER LP, HAWTHORN SURGERY CENTER | 582065044 - (IL) HAWTHORN PLACE OUTPATIENT SURGERY CENTER LP | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36013 | $216.00 | 1841226552 - NAPLES EYE SURGERY CENTER LLC | 20657002 - (FL) NAPLES EYE SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36013 | $646.80 | 1417944778 - MERRIMACK VALLEY ENDOSCOPY CENTER | 43578297 - (MA) MERRIMACK VALLEY ENDOSCOPY CENTER | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36013 | $487.00 | 1558612762 - QUEENS BOULEVARD ASC LLC | 274614930 | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36013 | $566.00 | 1902959190 - RIVA ROAD SURGICAL CENTER, LLC | 870774597 - (MD) RIVA ROAD SURGICAL CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36013 | $108.00 | 1417080342 - MORGANTON EYE PHYSICIANS, P.A., EYE SURGERY CENTER OF SHELBY | 561109834 - (NC) MORGANTON EYE PHYSICIANS, P.A. | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36013 | $175.00 | 1730514027 - KY ADVANCED SURGICAL CENTER INC | 901005366 - (CA) KY ADVANCED SURGICAL CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36013 | $562.00 | 1053362343 - SODERSTROM DERMATOLOGY CENTER S C, PEORIA AMBULATORY SURGERY CENTER | 371001642 - (IL) SODERSTROM DERMATOLOGY CENTER, S.C. | IL | 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 36013 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 36013 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 36013 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 |
| 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 |
| 36014-CPT | Moderate | Select Cath Plcmt Lt/Rt Pulmny Art |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 36013. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 36013 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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