CPT 36225 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 • 59 - Distinct Procedural Service • LT - Left side of body |
| Complexity Level | High |
National average reimbursement for CPT 36225 by major payers:
$1,678.52
$2,120.93
$2,280.59
$2,480.12
| 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 36225 | ||||||
United | 36225 | $1900.00 | 1922531268 - AMERICAN ACCESS CARE OF BALTIMORE ASC LLC | 814584087 - (MD) AMERICAN ACCESS CARE OF BALTIMORE ASC LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36225 | $2359.00 | 1497201867 - ABILENE CENTER FOR ORTHOPEDIC AND MULTISPECIALTY SURGERY, L.L.C. | 813619502 - (TX) ABILENE CENTER FOR ORTHOPEDIC AND MULTISPECIALTY SURGERY LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36225 | $1101.00 | 1629262274 - THE SURGERY CENTER OF THE VILLAGES, LLC, THE SURGERY CENTER OF THE VILLAGES | 208291654 - (FL) THE SURGERY CENTER OF THE VILLAGES LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36225 | $1000.00 | 1730153073 - EAST MEMPHIS UROLOGY CENTER, LP, UROCENTER | 621810940 - (TN) EAST MEMPHIS UROLOGY CENTER LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36225 | $1602.00 | 1528130879 - PACIFIC SURGICAL INSTITUTE OF PAIN MANAGEMENT | 330776873 - (CA) PACIFIC SURGICAL INSTITUTE OF PAIN MANAGEMENT | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36225 | $519.00 | 1225140510 - NORTHEAST AMBULATORY CENTER INC | 43382778 - (MA) NORTHEAST AMBULATORY CENTER, INC. | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36225 | $3014.00 | 1962059915 - BRIGHTSIDE SURGICAL, LLC | 831888619 - (ND) BRIGHTSIDE SURGICAL LLC | ND | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36225 | $1288.00 | 1932204971 - GREENVILLE ENDOSCOPY CENTER INC | 570965754 - (SC) GREENVILLE ENDOSCOPY CENTER INC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36225 | $3188.00 | 1760486369 - MOUNTAIN EMPIRE SURGERY CENTER LP | 621772667 - (TN) MOUNTAIN EMPIRE SURGERY CENTER LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36225 | $3623.00 | 1811515034 - SALMON SURGERY CENTER LLC | 844895716 - (WA) SALMON SURGERY CENTER LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36225 | $1800.00 | 1760196984 - JACKSON HEART AND VASCULAR CENTER LLC | 870947298 - (MS) JACKSON HEART AND VASCULAR CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36225 | $781.00 | 1558451583 - LIPPY SURGERY CENTER LLC | 205293709 - (OH) LIPPY SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36225 | $2358.00 | 1497746747 - PHYSICIANS' SURGERY CENTER OF VICTORVILLE LLC | 260057464 - (CA) PHYSICIANS SURGERY CENTER OF VICTORVILLE, LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36225 | $1183.56 | 1104208164 - JOSEPH ANTHONY | 350593390 - DEACONESS HOSPITAL INC | IL | Certified Registered Nurse Anesthetist (367500000X) |
United | 36225 | $2795.00 | 1205875283 - RWJ ENDOSURGICAL CENTER LLC | 900872940 - (NJ) RWJ ENDOSURGICAL CENTER LLC | NJ | 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 36225 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 36225 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 36225 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 |
| 36225-CPT | High | Selective Catheter Placement Subclavian Or In- Ominate Artery Unilateral With Angiography Of The Ipsilateral Vertebral Circulation And All As- Sociated Radiological Supervision And Interpreta- Tion Includes Angiography Of The 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 36225. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 36225 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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