CPT 36160 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 |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 51 - Multiple procedures |
| Complexity Level | Moderate |
National average reimbursement for CPT 36160 by major payers:
$619.17
$711.67
$763.55
$868.75
| 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 36160 | ||||||
United | 36160 | $425.00 | 1376538876 - THE ENDOSCOPY CENTER OF BRISTOL | 621727371 - (TN) THE ENDOSCOPY CENTER OF BRISTOL | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36160 | $234.00 | 1629142666 - ENDOSCOPY CENTER OF BUCKS COUNTY, LP | 841693856 - (PA) ENDOSCOPY CENTER OF BUCKS COUNTY LP | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36160 | $564.00 | 1306905815 - UAS MANAGEMENT, INC., UNIVERSITY SURGERY CENTER | 611845381 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36160 | $179.00 | 1447366224 - WEST MICHIGAN SURGERY CENTER, LLC | 371509502 - (MI) MICHIGAN PRIMARY CARE PARTNERS PC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36160 | $286.00 | 1255728499 - SUMMIT ATLANTIC SURGERY CENTER LLC | 473235212 - (NJ) SUMMIT ATLANTIC SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36160 | $388.00 | 1689633588 - SOUTH JERSEY ENDOSCOPY LLC, DIMARINO-KROOP-PRIETO GI ASSOC | 200478348 - (NJ) SOUTH JERSEY ENDOSCOPY LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36160 | $53.00 | 1780661967 - CJ ELMWOOD PARTNERS L P | 911793912 - CJ ELMWOOD PARTNERS L P | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36160 | $102.00 | 1437120953 - MONTGOMERY SURGERY CENTER LIMITED PARTNERSHIP | 521401868 - (MD) MONTGOMERY SURGERY CENTER LIMITED PARTNERSHIP | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36160 | $91.00 | 1720081664 - HEATON LASER AND SURGERY CENTER L L C | 752752100 - (TX) HEATON LASER AND SURGERY CENTER L L C | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36160 | $200.00 | 1083606867 - NOVAMED SURGERY CENTER OF TYLER, LP, CATARACT CENTER OF EAST TEXAS | 680510003 - (TX) NOVAMED SURGERY CENTER OF TYLER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36160 | $102.00 | 1073556338 - VALDOSTA PODIATRY ASSOCIATES, PC, NORTH OAK AMBULATORY SURGERY CENTER | 261479859 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36160 | $258.00 | 1902428477 - EASTSIDE SURGERY CENTER, LLC | 261980849 - (AZ) PAINMDS AMBULATORY SURGICAL CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36160 | $235.00 | 1871119107 - REGIONAL PLASTIC SURGERY CENTER PA, REGIONAL PLASTIC SURGERY CENTER - SHERMAN | 752365055 - (TX) REGIONAL PLASTIC SURGERY ASSOCIATES, P.A. | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36160 | $139.00 | 1548785116 - NEPHROLOGY & INTERNAL MEDICINE, INC., NEPHROLOGY & INTERNAL MEDICINE INC | 351298573 - (IN) NEPHROLOGY & INTERNAL MEDICINE, INC. | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36160 | $688.00 | 1811994080 - PACIFIC ENDO-SURGICAL CENTER, LP, PACIFIC ENDO-SURGICAL CENTER | 562387275 - (CA) PACIFIC ENDOSURGICAL CENTER LP | CA | 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 36160 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 36160 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 36160 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 |
|---|---|---|
| 36140-CPT | Moderate | Introduction Of Needle Or Intracatheter Upper Or Lower Extremity Artery. (Desc Revised 1/1/2018) |
| 36160-CPT | Moderate | Introduce Needleor Intracath,Aortic,Tra |
| 36200-CPT | Moderate | Introduction Of Catheter, Aorta (Arch, Abdominal, Midstream Renal, Aortoiliac Run-Off) Or Selective; Initial Placement |
| 36215-CPT | High | Selective Catheter Placement, Arterial System; Each First Order Thoracic Or Brachiocephalic Branch, Within A Vascular Family |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 36160. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 36160 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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