CPT 36246 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 • 11 - Office |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 36246 |
National average reimbursement for CPT 36246 by major payers:
$1,079.01
$1,273.65
$1,389.71
$1,377.73
| 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 36246 | ||||||
United | 36246 | $208.00 | 1689632119 - CHILDREN'S WEST SURGERY CENTER | 621872553 - (TN) CHILDRENS WEST SURGERY CENTER | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36246 | $140.00 | 1619517539 - MOUNTAIN WEST DERM | 813253496 | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36246 | $157.00 | 1053059220 - CENTURION SURGERY CENTER OF JACKSONVILLE, LLC, CENTURION SURGERY CENTER OF JACKSONVILLE | 843958857 - (FL) CENTURION SURGERY CENTER OF JACKSONVILLE LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36246 | $450.00 | 1316009194 - ADVOCATE SOUTHWEST AMBULATORY SURGERY CENTER LLC, TINLEY WOODS SURGERY CENTER | 364437931 - (IL) ADVOCATE SOUTHWEST AMBULATORY SURGE | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36246 | $90.00 | 1265438303 - EYE SURGERY CENTER OF CHATTANOOGA, LLC | 200149350 - (TN) EYE SURGERY CENTER OF CHATTANOOGA LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36246 | $37.00 | 1194999359 - JEFFREY L BOBER DPM PA, JEFFREY L BOBER DPM PA ASC | 521706931 - (MD) JEFFREY L BOBER DPM PA | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36246 | $85.00 | 1255872784 - MIDATLANTIC ENDOSCOPY LLC, MID-ATLANTIC GASTROINTESTINAL CENTER | 814079161 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36246 | $946.00 | 1336209451 - SADDLE RIVER VALLEY SURGICAL CENTER LLC, SADDLE RIVER VALLEY SURGICAL CENTER LLC | 201250583 - (NJ) SADDLE RIVER VALLEY SURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36246 | $641.00 | 1780021188 - ENDOSCOPY CENTER OF NIAGARA, LLC | 453630889 - (NY) ENDOSCOPY CENTER OF NIAGARA LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36246 | $555.00 | 1215116611 - UPPER BAY SURGERY CENTER, LLC | 205547410 - (MD) UPPER BAY SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36246 | $688.00 | 1467405837 - PARKCREEK SURGERY CENTER LLLP | 843082809 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36246 | $120.00 | 1730570003 - SMART PAIN SURGERY CENTER AT GERMANTOWN, LLC, CLEARWAY SURGERY CENTER OF GERMANTOWN | 472908671 - (MD) SMART PAIN SURGERY CENTER AT GERMANTOWN LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36246 | $652.00 | 1356903967 - UNITY LINDEN OAKS SURGERY CENTER | 800798208 | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36246 | $500.00 | 1841672615 - ALLIANCE SURGERY CENTER AT AUGUSTA, LLC | 474382081 - (GA) ALLIANCE SURGERY CENTER AT AUGUSTA LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36246 | $1081.00 | 1871838003 - NORTHWEST REGIONAL SURGERY CENTER, LLC | 460823847 - (IN) NORTHWEST REGIONAL SURGERY CENTER LLC | IN | 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 36246 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 36246 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 36246 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 36246. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 36246 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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