CPT 36400 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 | • 11 - Office • 99 - Other POS |
| Common Modifiers | • None • EP - Residential facility to Physician's office • 59 - Distinct Procedural Service |
| Complexity Level | Low |
National average reimbursement for CPT 36400 by major payers:
$35.87
$36.91
$40.71
$44.70
| 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 36400 | ||||||
United | 36400 | $60.00 | 1801164967 - DA PEDIATRIC REHABILITATION | 270939565 - (FL) DA PEDIATRIC REHABILITATION | FL | Home Health Agency (251E00000X) |
United | 36400 | $47.29 | 1891224200 - KYLE KOPATICH | 350593390 - DEACONESS HOSPITAL INC | IN | Hospitalist Physician (208M00000X) |
United | 36400 | $47.29 | 1265675193 - AMY GESSFORD | 350593390 - DEACONESS HOSPITAL INC | LA | Hospitalist Physician (208M00000X) |
United | 36400 | $47.29 | 1568935344 - JAMES GILSTRAP | 350593390 - DEACONESS HOSPITAL INC | MO | Certified Registered Nurse Anesthetist (367500000X) |
United | 36400 | $47.29 | 1821440801 - RAUL RAMIREZ VELAZQUEZ | 350593390 - DEACONESS HOSPITAL INC | IN | Hospitalist Physician (208M00000X) |
United | 36400 | $47.29 | 1699841874 - RAMA CHILUKURI | 350593390 - DEACONESS HOSPITAL INC | IN | Hospitalist Physician (208M00000X) |
United | 36400 | $47.29 | 1720055171 - MARK JANORSCHKE | 350593390 - DEACONESS HOSPITAL INC | MN | Certified Registered Nurse Anesthetist (367500000X) |
United | 36400 | $21.72 | 1124041884 - ECHO REARDON | 350593390 - DEACONESS HOSPITAL INC | MO | Certified Registered Nurse Anesthetist (367500000X) |
United | 36400 | $47.29 | 1659963510 - THOMAS HORNYAK | 350593390 - DEACONESS HOSPITAL INC | PA | Certified Registered Nurse Anesthetist (367500000X) |
United | 36400 | $47.29 | 1386962223 - KELLI MATHEW | 350593390 - DEACONESS HOSPITAL INC | KY | Pulmonary Disease Physician (207RP1001X) |
United | 36400 | $47.29 | 1861840779 - JESSICA TRIMER | 350593390 - DEACONESS HOSPITAL INC | WV | Certified Registered Nurse Anesthetist (367500000X) |
United | 36400 | $47.29 | 1518062819 - AZIZULLAH MEHRZAD | 350593390 - DEACONESS HOSPITAL INC | KY | Geriatric Medicine (Internal Medicine) Physician (207RG0300X) |
United | 36400 | $7.57 | 1366400376 - SUNRISE HOME HEALTH CARE INC. | 650307774 - (FL) SUNRISE HOME HEALTH CARE INC | FL | Home Health Agency (251E00000X) |
United | 36400 | $47.29 | 1497733257 - PALLAVI BHATT | 350593390 - DEACONESS HOSPITAL INC | IN | Anesthesiology Physician (207L00000X) |
United | 36400 | $47.29 | 1629162573 - DEACONESS HOSPITAL, INC, <UNAVAIL> | 350593390 - DEACONESS HOSPITAL INC | IN | Anesthesiology Physician (207L00000X) |
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 36400 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 36400 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 36400 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 |
|---|---|---|
| 36400-CPT | Low | Venipuncture Younger Than Age 3 Years Necessi- Tating The Skill Of A Physician Or Other Qualifiedhealth Care Professional Not To Be Used For Routine Venipuncture; Femoral Or Jugular Vein (Revised 1/1/2013) |
| 36405-CPT | Low | Venipuncture Younger Than Age 3 Years Necessi Tating The Skill Of A Physician Or Other Qualified Health Care Professional Not To Be Usedfor Routine Venipuncture; Scalp Vein (Revised 1/1/2013) |
| 36406-CPT | Low | Venipuncture Younger Than Age 3 Years Necessi- Tating The Skill Of A Physician Or Other Qualifiedhealth Care Professional Not To Be Used For For Routine Venipuncture; Other Vein (Rvsd 1/1/13) |
| 36410-CPT | Low | Venipuncture Age 3 Years Or Older Necessitating The Skill Of A Physician Or Other Qualified Healthcare Professional (Separate Procedure) For Diag- Nostic Or Therapeutic Purposes (Not To Be Used Forroutine Venipuncture) (Revised 1/1/2013) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 36400. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 36400 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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