CPT 36223 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 50 - Bilateral Procedure • 59 - Distinct Procedural Service |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 36223 |
National average reimbursement for CPT 36223 by major payers:
$1,765.04
$2,182.09
$2,356.36
$2,586.46
| 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 36223 | ||||||
United | 36223 | $2566.00 | 1154481984 - SPRING VALLEY SURGERY CENTER, LLC | 880512805 - (NV) SPRING VALLEY SURGERY CENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36223 | $1839.00 | 1164083911 - EVERETT ROAD ASC, LLC, EVERETT ROAD SURGERY CENTER | 833542382 - (NY) EVERETT ROAD ASC LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36223 | $3833.00 | 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 | 36223 | $4031.00 | 1164527933 - NORTHWEST AMBULATORY SURGERY SERVICES, LLC, BELLINGHAM AMBULATORY SURGERY CENTER | 911830115 - (WA) NORTHWEST AMBULATORY SURGERY SERVICES, LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36223 | $1479.00 | 1295710317 - CENTRAL FLORIDA ENDOSCOPY & SURGICAL INSTITUTE OF OCALA LLC | 203520333 - (FL) CENTRAL FLORIDA ENDOSCOPY SURGICAL INSTITUTE OF OCALA LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36223 | $1390.00 | 1730382789 - ENDOSCOPY CENTER | 260317060 - (NC) ENDOSCOPY CENTER | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36223 | $6492.00 | 1427003052 - EYE SURGERY CENTER OF NASHVILLE LLC | 621872622 - (TN) EYE SURGERY CENTER OF NASHVILLE LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36223 | $2258.00 | 1780117440 - INSIGHT SURGERY CENTER, LLC | 813772336 - (CO) INSIGHT SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36223 | $3800.00 | 1588679179 - SPECIALTY SURGICAL CENTER OF ENCINO LP | 954816334 - (CA) SPECIALTY SURGICAL CENTER OF ENCINO, LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36223 | $991.00 | 1649376757 - ADS HEALTHCARE LLC, ADS AMBULATORY SURGERY CENTER | 481207671 - (KS) ADS HEALTHCARE LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36223 | $2489.00 | 1003909789 - OREGON TRAIL EYE SURGERY CENTER, INC | 200121578 - (NE) OREGON TRAIL EYE SURGERY CENTER INC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36223 | $1700.00 | 1104228931 - GLENNVILLE EYE SURGERY CENTER LLC | 463019697 - (GA) GLENNVILLE EYE SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36223 | $2632.00 | 1720024284 - PMA SURGERY CENTER, LLC | 721550480 - (TN) PMA SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36223 | $4909.00 | 1972911030 - SOUTHEASTERN AMBULATORY SURGERY CENTER, LLC, THE SURGERY CENTER AT SOUTHEASTERN HEALTH PARK | 452413077 - (NC) SOUTHEASTERN AMBULATORY SURGERY CENTER, LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36223 | $3391.00 | 1023199601 - ANNE ARUNDEL UROLOGICAL SURGERY CENTER LLC | 522012685 | MD | 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 36223 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 36223 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 36223 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 |
|---|---|---|
| 36221-CPT | High | Non-Selective Catheter Placement Thoracic Aorta With Angiography Of The Extracranial Carotid Vertebral And/Or Intracranial Vessels Unilateralor Bilateral And All Associated Radiological Supervision And Interpretation Includes Angio- Graphy Of The Cervicocerebral Arch When Performed |
| 36222-CPT | High | Selective Catheter Placement Common Carotid Or Innominate Artery Unilateral Any Approach With Angiography Of The Ipsilateral Extracranial Ca- Rotid Circulation And All Associated Radiological Supervision And Interpretation Includes Angiogra-Phy Of The Cervicocerebral Arch When Performed |
| 36223-CPT | High | Selective Catheter Placement Common Carotid Or Innominate Artery Unilateral Any Approach With Angiography Of The Ipsilateral Intracranial Ca- Rotid Circulation And All Associated Radiological Supervision And Interpretation Includes Angiogra-Phy Of The Extracranial Carotid And Cervicocere- Bral Arch When Performed |
| 36224-CPT | High | Selective Catheter Placement Internal Carotid Artery Unilateral With Angiography Of The Ipsilateral Intracranial Carotid Circulation And All Associated Radiological Supervision And Interpretation Includes Angiography Of The Extracranial Carotid And Cervicocerebral Arch When Performed |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 36223. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 36223 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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