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See a sample rate comparisonCPT 36245 Fee Schedule
Last Verified: October 2026
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.
Catheter Placement Artery, Surgical Insertion Of A Thin Tube (Catheter) Into An Artery. The Catheter Is Guided To Branch Arteries In The Abdomen Pelvis Or Legs. Dye May Be Injected For X-Ray Examination.
| 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 | 59 - Distinct Procedural Service XS - Separate Structure |
| Complexity Level | High |
| Medicare Fee Schedule | $1,198.76 national non-facility rate (2026) · View Medicare rates for 36245 |
| Medicaid Fee Schedule | $961.50 median of the 8 states in the free preview · View Medicaid rates for 36245 |
National average reimbursement for CPT 36245 by major payers:
$1,354.11
$1,714.35
$1,880.38
$507.46
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CPT 36245
5 of 25 sample ratesHigher to lower in this preview
Amy Treece
Prisma Health-University Medical Group
$2,943.06Published rateSpencer Greenwood
Deaconess Hospital Inc
$2,290.80Published rateEsmeralda Espinoza Martinez
Deaconess Hospital Inc
$1,052.53Published rateSusan Taylor
Erlanger Medical Center
$307.13Published rateCentral Ohio Gastroenterology Associates,LLC, Mid Ohio Surgery Center
Central Ohio Gastroenterology Associatesllc
$106.00Published rate
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See a sample payer proposalCPT 36245 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 36245 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 36245 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 |
|---|---|---|
| 36245-CPT | High | Catheter Placement Artery, Surgical Insertion Of A Thin Tube (Catheter) Into An Artery. The Catheter Is Guided To Branch Arteries In The Abdomen Pelvis Or Legs. Dye May Be Injected For X-Ray Examination. |
| 36246-CPT | High | Catheter Placement Artery, Surgical Insertion Of A Thin Tube (Catheter) Into An Artery. The Catheter Is Guided To Branch Arteries In The Abdomen Pelvis Or Legs. Dye May Be Injected For X-Ray Examination. |
| 36247-CPT | High | Catheter Placement Artery, Surgical Insertion Of A Thin Tube (Catheter) Into An Artery. The Catheter Is Guided To Branch Arteries In The Abdomen Pelvis Or Legs. Dye May Be Injected For X-Ray Examination. |
| 36248-CPT | Low | Ins Cath Abd L Ext Art Addl, Selective Catheter Placement Arterial System Additional Second Order Third Order And Beyond Abdominal Pelvic Or Lower Extremity Artery Branch Within A Vascular Family List In Addition To Code For Initial Second Or Third Order Vessel As Appropriate |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 36245. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 36245 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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Frequently Asked Questions
CPT stands for Current Procedural Terminology. CPT codes are standardized five-digit codes used by healthcare providers to describe medical, surgical, and diagnostic services to health insurance companies. They are essential for billing and processing claims for these services.
Finding the exact cost of a medical procedure can be complex due to varying factors like your insurance plan, location, and specific provider. You can often get an estimate by contacting your insurance provider directly or the healthcare facility where you plan to receive services. For a more precise estimate based on CPT codes and your specific location, you can use tools like Payerprice.
A fee schedule is a comprehensive list of fees used by health insurers or government programs (like Medicare and Medicaid) to pay providers and suppliers. It outlines the maximum amount that will be reimbursed for specific healthcare services, which are typically identified by CPT codes. Healthcare providers may also have their own fee schedules, and insurance companies often negotiate their own rates with providers.
Medical costs vary significantly due to a multitude of factors, including geographic location, the specific healthcare provider or facility, the patient's insurance plan (and their negotiated rates), the complexity of the service, and whether the provider is in-network or out-of-network. Different providers have varying overhead costs and negotiate different rates with insurance companies, leading to wide price discrepancies for the same service.
For specific CPT code pricing based on your location, you can utilize online tools designed for this purpose. Payerprice offers a fee schedule lookup tool that allows users to search with a CPT code and specific location to obtain relevant pricing information. This can help you understand potential costs before receiving a service.
Billed charges are the initial prices a healthcare provider sets for a service before any adjustments or discounts. What you actually pay, often referred to as your out-of-pocket cost, is typically much lower than the billed charge. This is because insurance companies negotiate discounted rates with providers, and your payment will be based on your plan's deductible, co-insurance, and co-payment after those negotiated rates are applied. The difference between the billed charge and the negotiated rate is often "written off" by the provider.