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 |
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 | $200.00 | 1750609731 - BELTLINE SURGERY CENTER, LLC | 262639054 - (TX) BELTLINE SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36246 | $208.00 | 1689632119 - CHILDREN'S WEST SURGERY CENTER | 621872553 - (TN) CHILDRENS WEST SURGERY CENTER | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36246 | $115.00 | 1518998764 - TENNESSEE PAIN SURGERY CENTER, LLC | 621790133 - (TN) TENNESSEE PAIN SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36246 | $230.00 | 1801825880 - SURGERY CENTER AT RIVER ROAD, LLC, AESTHETIC SURGERY AT HACIENDA DEL SOL | 760824670 - (AZ) SURGERY CENTER AT RIVER ROAD, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36246 | $557.00 | 1629032446 - AMBULATORY SURGERY CENTER GROUP LTD | 592073099 - (FL) AMBULATORY SURGERY CENTER GROUP LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36246 | $1708.00 | 1649218009 - RIVER DRIVE SURGERY CENTER, LLC, RIVER DRIVE SURGERY AND LASER CENTER | 223672648 - (NJ) RIVER DRIVE SURGERY CENTER L L | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36246 | $574.00 | 1194239483 - ATLANTIC COAST SURGICAL SUITES, LLC | 822449256 - (NH) ATLANTIC COAST SURGICAL SUITES LLC | NH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36246 | $175.00 | 1225377278 - CENTER FOR MINIMALLY INVASIVE SURGERY PLLC, SOUNDVIEW AMBULATORY SURGERY CENTER | 911661866 - (WA) CENTER FOR MINIMALLY INVASIVE SURGERY, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36246 | $126.00 | 1093757379 - ASC DEVELOPMENT COMPANY, LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36246 | $70.00 | 1558787614 - DIGESTIVE CARE ENDOSCOPY | 464923646 - (GA) DIGESTIVE CARE ENDOSCOPY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36246 | $108.00 | 1972675668 - TEXAS REGIONAL EYE CENTER ASC LLC, TEXAS REGIONAL EYE CENTER ASC LLC | 710967940 - (TX) TEXAS REGIONAL EYE CENTER ASC LLC | TX | 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 | $406.00 | 1205454626 - EYE SURGERY CENTER OF WISCONSIN, LLC | 833779684 - (WI) EYE SURGERY CENTER OF WISCONSIN, LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36246 | $664.00 | 1598927147 - MORTON PLANT MEASE HEALTH SERVICES INC, BARDMOOR OUTPATIENT CENTER | 204385452 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36246 | $236.00 | 1316940539 - GRAND ISLAND SURGICAL CENTER LLC | 470811846 - (NE) GRAND ISLAND SURGICAL CENTER, L.L.C. | NE | 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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