CPT 36245 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 • XS - Separate Structure |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 36245 |
National average reimbursement for CPT 36245 by major payers:
$1,354.11
$1,714.35
$1,880.38
$1,952.95
| 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 36245 | ||||||
United | 36245 | $1471.53 | 1518259977 - HINA CHAUDHRY | 853861695 - MUSC COMMUNITY PHYSICIANS | SC | Pulmonary Disease Physician (207RP1001X) |
United | 36245 | $1052.53 | 1730756552 - ESMERALDA ESPINOZA MARTINEZ | 350593390 - DEACONESS HOSPITAL INC | IN | Certified Registered Nurse Anesthetist (367500000X) |
United | 36245 | $2290.80 | 1790275766 - SPENCER GREENWOOD | 350593390 - DEACONESS HOSPITAL INC | IN | Certified Registered Nurse Anesthetist (367500000X) |
United | 36245 | $688.00 | 1538773890 - ASC OF TRINITY, COMPREHENSIVE OUTPATIENT JOINT AND SPINE INSTITUTE | 833008593 - (FL) ASC OF TRINITY | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36245 | $2630.37 | 1558971390 - AURYELLE ASCUE | 570828733 - ROPER HOSPITAL INC | SC | Acute Care Nurse Practitioner (363LA2100X) |
United | 36245 | $211.36 | 1376696898 - GEORGE AUGUSTINE | 582404034 - (SC) ORANGEBURG LUNG ASSOCIATES, P.A. | SC | Pulmonary Disease Physician (207RP1001X) |
United | 36245 | $2943.06 | 1417172529 - AMY TREECE | 571004971 - PRISMA HEALTH-UNIVERSITY MEDICAL GROUP | SC | Pulmonary Disease Physician (207RP1001X) |
United | 36245 | $775.10 | 1700897048 - KENNETH KALASSIAN | 593214635 - FLORIDA HOSPITAL MEDICAL GROUP INC | PA | Pulmonary Disease Physician (207RP1001X) |
United | 36245 | $158.00 | 1457329963 - SEQUOIA SURGERY CENTER, LLC, CYPRESS SURGERY CENTER, A LIMITED PARTNERSHIP | 770326275 - (CA) SEQUOIA SURGERY CENTER, LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36245 | $106.00 | 1104835776 - CENTRAL OHIO GASTROENTEROLOGY ASSOCIATES,LLC, MID OHIO SURGERY CENTER | 204751805 - (OH) CENTRAL OHIO GASTROENTEROLOGY ASSOCIATESLLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36245 | $1107.25 | 1093592644 - ANSIBLE HEALTH MEDICAL GROUP PA | 883238466 | DC | Pulmonary Disease Physician (207RP1001X) |
United | 36245 | $2943.06 | 1891180980 - MICHAEL KASTER | 571004971 - PRISMA HEALTH-UNIVERSITY MEDICAL GROUP | NE | Pulmonary Disease Physician (207RP1001X) |
United | 36245 | $595.00 | 1568505899 - BON SECOURS SURGERY CENTER AT HARBOUR VIEW, LLC, BON SECOURS SURGERY CENTER AT HARBOUR VIEW | 208302537 - (VA) BON SECOURS SURGERY CENTER AT HARBOUR VIEW LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36245 | $1130.17 | 1851771786 - RYAN LOK | 570978524 - (SC) LOWCOUNTRY LUNG AND CRITICAL CARE P.A. | IN | Critical Care Medicine (Internal Medicine) Physician (207RC0200X) |
United | 36245 | $592.00 | 1043246077 - DUTCHESS AMBULATORY SURGICAL CENTER | 141803011 - (NY) DUTCHESS AMBULATORY SURGICAL CENTER | NY | 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 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 | Selective Catheter Placement, Arterial System; Each First Order Abdominal, Pelvic, Or Lower Extremity Artery Branch, Within A Vascular Family |
| 36246-CPT | High | Selective Catheter Placement, Arterial System; Initial Second Order Abdominal, Pelvic, Or Lower Extremity Artery Branch, Within A Vascular Family |
| 36247-CPT | High | Selective Catheter Placement, Arterial System; Initial Third Order Or More Selective Abdominal, Pelvic, Or Lower Extremity Artery Branch, Within A Vascular Family |
| 36248-CPT | Low | 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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