CPT 36215 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 | • 11 - Office • 24 - Ambulatory Surgical Center • 21 - Inpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 51 - Multiple procedures |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 36215 |
National average reimbursement for CPT 36215 by major payers:
$1,161.17
$1,447.28
$1,604.62
$1,648.34
| 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 36215 | ||||||
United | 36215 | $1560.79 | 1366437493 - GEORGE KARTALIAN, JR. | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Orthopaedic Surgery Physician (207X00000X) |
United | 36215 | $1538.94 | 1801813266 - GREGG BEAN | 741586031 | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 36215 | $1404.71 | 1053764811 - DANIELLE EGANHOUSE | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Physician Assistant (363A00000X) |
United | 36215 | $2735.72 | 1427014182 - SARAH SCHAEFER | 454832340 | NJ | Surgical Oncology Physician (2086X0206X) |
United | 36215 | $2972.14 | 1528329158 - JOSEPH DEMARCO | 454832340 | NJ | Diagnostic Radiology Physician (2085R0202X) |
United | 36215 | $3394.25 | 1255478004 - CHRISTOPHER RAIO | 208243412 - SAMARITAN EMERGENCY MEDICAL SERVICES PC | NY | Emergency Medicine Physician (207P00000X) |
United | 36215 | $1802.68 | 1285968149 - CHRISTOPHER DIPIRO | 350593390 - DEACONESS HOSPITAL INC | IN | Family Medicine Physician (207Q00000X) |
United | 36215 | $863.79 | 1053866707 - BRITTANY PTACHICK | 541958039 - HROA 401K PLAN | VA | Family Nurse Practitioner (363LF0000X) |
United | 36215 | $867.94 | 1669487484 - GUADALUPE MACIAS | 132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION | NY | Internal Medicine Physician (207R00000X) |
United | 36215 | $2972.14 | 1952562019 - GINA CAMBARERI | 454832340 | NJ | Pediatric Urology Physician (2088P0231X) |
United | 36215 | $2810.04 | 1255478004 - CHRISTOPHER RAIO | 112050523 - ST FRANCIS HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | 36215 | $828.26 | 1871000133 - BENJAMIN CHRISTIAN | 350593390 - DEACONESS HOSPITAL INC | KY | Certified Registered Nurse Anesthetist (367500000X) |
United | 36215 | $3106.52 | 1255478004 - CHRISTOPHER RAIO | 112050523 - ST FRANCIS HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | 36215 | $952.58 | 1669487484 - GUADALUPE MACIAS | 132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION | NY | Internal Medicine Physician (207R00000X) |
United | 36215 | $1411.29 | 1861855900 - ABBAS NAQVI | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | FL | Orthopaedic Surgery Physician (207X00000X) |
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 36215 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 36215 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 36215 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) |
| 36215-CPT | High | Selective Catheter Placement, Arterial System; Each First Order Thoracic Or Brachiocephalic Branch, Within A Vascular Family |
| 36216-CPT | High | Selective Catheter Placement, Arterial System; Initial Second Order Thoracic Or Brachiocephalic Branch, Within A Vascular Family |
| 36217-CPT | High | Selective Catheter Placement, Arterial System; Initial Third Order Or More Selective 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 36215. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 36215 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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