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See a sample rate comparisonCPT 36247 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 | 11 - Office 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | RT - Right side of body 59 - Distinct Procedural Service |
| Complexity Level | High |
| Medicare Fee Schedule | $1,356.08 national non-facility rate (2026) · View Medicare rates for 36247 |
| Medicaid Fee Schedule | $1,088.355 median of the 8 states in the free preview · View Medicaid rates for 36247 |
National average reimbursement for CPT 36247 by major payers:
$1,793.77
$2,155.51
$2,356.62
$634.15
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CPT 36247
5 of 25 sample ratesHigher to lower in this preview
Bradley Smith
Emergeortho, P.A.
$2,745.93Published rateSouthlake Ambulatory Surgery Center, Lllp, Spivey Station Surgery Center
Emory University
$1,250.00Published rateChristus Santa Rosa Outpatient Surgery, Christus Physicians Surgery Center - New Braunfels
$365.00Published rateCenturion Surgery Center Of Jacksonville, LLC, Centurion Surgery Center Of Jacksonville
Centurion Surgery Center Of Jacksonville LLC
$157.00Published rateThe Asc At Waugh Chapel
$43.00Published rate
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See a sample payer proposalCPT 36247 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 36247 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 36247 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 36247. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 36247 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
To get an estimate for a medical procedure or service, you can first ask your provider for the specific CPT (Current Procedural Terminology) codes for the services you expect to receive. Once you have these codes, you can use a tool like Payerprice's fee schedule lookup tool. This platform allows you to search for the expected costs based on the CPT code and your specific location, helping you understand potential charges. You should also contact your insurance provider to understand your coverage, deductible, copay, and coinsurance responsibilities.
A CPT (Current Procedural Terminology) code is a five-digit numerical code used by medical professionals to describe and bill for medical, surgical, and diagnostic services. Each code precisely identifies a specific service performed by a healthcare provider. CPT codes are crucial for understanding healthcare costs because they standardize billing across the industry. When you have the CPT code for a service, you can use it to research the typical cost of that service (e.g., using Payerprice) and inquire with your insurance company about your coverage for that specific procedure.
Your health insurance plan significantly impacts the final cost you pay through several mechanisms: * **Deductible:** This is the amount you must pay out-of-pocket for covered services before your insurance plan starts to pay. * **Copayment (Copay):** A fixed amount you pay for a covered health care service after you've paid your deductible. * **Coinsurance:** Your share of the cost for a covered health care service, calculated as a percentage (e.g., 20%) of the allowed amount for the service, after you've met your deductible. * **Out-of-Pocket Maximum:** The most you have to pay for covered services in a plan year. After you reach this amount, your insurance plan pays 100% of the cost of covered benefits. Understanding these terms and your plan's specific details is essential for predicting your financial responsibility.
For specific fee schedule information related to CPT codes in your particular location, you should utilize Payerprice. Payerprice offers a dedicated fee schedule lookup tool where you can input the CPT code for a medical service along with your location to find relevant pricing data. This tool is designed to provide transparency on costs, helping you make informed decisions about your healthcare expenditures.