CPT 36260 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-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 • 51 - Multiple procedures • GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
National average reimbursement for CPT 36260 by major payers:
$824.94
$874.39
$940.23
$1,071.77
| 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 36260 | ||||||
United | 36260 | $3515.00 | 1164771762 - MARYLAND SPECIALTY SURGERY CENTER, LLC | 454793230 - (MD) MARYLAND SPECIALTY SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36260 | $1700.00 | 1780624171 - C & S MEDICAL, LLC, DELAWARE SURGICAL ARTS | 200914212 - (DE) C S MEDICAL LLC | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36260 | $4215.00 | 1750376836 - ST. PETER'S AMBULATORY SURGERY CENTER LLC, ST. PETER'S SURGERY & ENDOSCOPY CENTER | 460463892 - (NY) ST. PETER'S AMBULATORY SURGERY CENTER, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36260 | $3800.00 | 1376558965 - SPECIALTY SURGICAL CENTER OF BEVERLY HILLS LP, SPECIALTY SURGICAL CENTER | 200140317 - (CA) SPECIALTY SURGICAL CENTER OF BEVERLY HILLS, LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36260 | $3300.00 | 1881461705 - GLACIER SURGICAL CENTER, LLC | 861271667 | MT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36260 | $1844.00 | 1578986550 - SUMMERVILLE ENDOSCOPY CENTER, LLC | 455241903 - (SC) SUMMERVILLE ENDOSCOPY CENTER LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36260 | $6588.00 | 1093085904 - ARIZONA ADVANCED ENDOSCOPY LLC | 453051125 - (AZ) ARIZONA ADVANCED ENDOSCOPY, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36260 | $6365.00 | 1184714214 - GAINESVILLE ENDOSCOPY CENTER, LLC | 10750801 - (GA) GAINESVILLE ENDOSCOPY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36260 | $6087.00 | 1942715826 - SAFETY HARBOR ASC COMPANY LLC, SAFETY HARBOR SURGERY CENTER | 320547161 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36260 | $7254.00 | 1386165504 - THE EMORY CLINIC INC, EMORY AMBULATORY SURGERY CENTER AT SPIVEY STATION | 582030692 - EMORY UNIVERSITY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36260 | $2115.00 | 1073621512 - DIGESTIVE DISEASE CENTER | 880291959 | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36260 | $1451.00 | 1659378800 - CITYVIEW SURGERY CENTER LLC, CITYVIEW SURGERY CENTER | 113711239 - (TX) CITYVIEW SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36260 | $2388.00 | 1184600736 - MERIDIAN SURGERY CENTER, LLC | 300160065 - (MS) MERIDIAN SURGERY CENTER, LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36260 | $4200.00 | 1780157990 - RENAISSANCE SURGERY CENTER, LLC | 832673907 - (TN) RENAISSANCE SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36260 | $1782.00 | 1629675285 - ORTHOARKANSAS SPINE INSTITUTE PROCEDURE CENTER LLC | 852741945 - (AR) ORTHOARKANSAS SPINE INSTITUTE PROCEDURE CENTER LLC | AR | 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 36260 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 36260 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 36260 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 36260. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 36260 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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