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 |
| Medicare Fee Schedule | View Medicare rates for 36260 |
| Medicaid Fee Schedule | View Medicaid rates for 36260 |
National average reimbursement for CPT 36260 by major payers:
$824.94
$874.39
$940.23
$1,046.85
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 36260 | $2208.00 | 1932204971 - GREENVILLE ENDOSCOPY CENTER INC | 570965754 - (SC) GREENVILLE ENDOSCOPY CENTER INC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36260 | $5920.00 | 1588746333 - TALLAHASSEE ORTHPAEDIC SURGERY PARTNERS LTD | 752535417 - (FL) TALLAHASSEE ORTHPAEDIC SURGERY PARTNERS LTD | FL | 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 | $7581.00 | 1770252868 - STONESPRINGS SURGICENTER, LLC | 812929320 - (VA) STONESPRINGS SURGICENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36260 | $1339.00 | 1639476377 - LIVONIA OUTPATIENT SURGERY CENTER, LLC | 261322609 - (MI) LIVONIA OUTPATIENT SURGERY CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36260 | $994.00 | 1558451583 - LIPPY SURGERY CENTER LLC | 205293709 - (OH) LIPPY SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36260 | $2035.00 | 1942202221 - NORTHLAKE ENDOSCOPY, LLC | 721515370 - (LA) NORTHLAKE ENDOSCOPY LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36260 | $6492.00 | 1437419660 - ADVANCED SURGERY CENTER OF METAIRIE LLC | 453386956 - (LA) ADVANCED SURGERY CENTER OF METAIRIE | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36260 | $1886.00 | 1528153111 - MECHANICSVILLE AMBULATORY SURGERY CENTER, LLC | 200767912 - (MD) MECHANICSVILLE AMBULATORY SURGERY CENTER LLC | MD | 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 | 36260 | $1324.00 | 1679566582 - FOREST CANYON ENDOSCOPY & SURGERY CTR PC | 460504121 - (AZ) FOREST CANYON ENDOSCOPY & SURGERY CENTER, PC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36260 | $4250.00 | 1770907172 - EYE AND LASER SURGERY CENTERS OF NEW JERSEY LLC | 462875016 - (NJ) EYE AND LASER SURGERY CENTERS OF NEW JERSEY LLC | NJ | 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 | $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 | $6492.00 | 1154474583 - CREEKWOOD SURGERY CENTER, LP | 431656044 - (MO) CREEKWOOD SURGERY CENTER LP | MO | 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.
| Code | Complexity | Description |
|---|---|---|
| 36260-CPT | Moderate | Place Infusion Device, Surgery To Insert A Device For Infusion Therapy Into An Artery. The Device Delivers Medication Over A Period Of Several Hours Such As For Chemotherapy. |
| 36261-CPT | Moderate | Revise Infusion Device, Surgery To Replace Recharge Or Refill A Pump Implanted Into An Artery. The Pump Delivers Medication Over A Period Of Hours. |
| 36262-CPT | Moderate | Removal Of Infusion Device, Surgery To Remove A Pump Implanted Into An Artery For Infusion Therapy. The Device Delivers Medication Over A Period Of Hours. |
| 36430-CPT | Low | Blood Transfusion, A Blood Transfusion Delivers Additional Or Needed Blood Or Blood Products. It May Be Manually Injected (Push Transfusion) Or As An Exchange Simultaneously While Blood Is Removed From The Body. |
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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