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See a sample rate comparisonCPT 36430 Fee Schedule
Last Verified: October 2026
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.
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.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Cardiovascular System |
| Common Place of Service | 23 - Emergency Room 21 - Inpatient Hospital |
| Common Modifiers | PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $47.43 national non-facility rate (2026) · View Medicare rates for 36430 |
| Medicaid Fee Schedule | $37.685 median of the 8 states in the free preview · View Medicaid rates for 36430 |
National average reimbursement for CPT 36430 by major payers:
$51.13
$48.90
$55.68
$66.76
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CPT 36430
5 of 25 sample ratesHigher to lower in this preview
Baylor Surgicare At Blue Star, LLC
Baylor Surgicare At Blue Star LLC
$1,446.00Published rateMinimally Invasive Surgicenter LLC
Minimally Invasive Surgicenter L
$555.00Published rateSunrise Surgery Center LLC
$171.00Published rateThe Center For Aesthetic Surgery LLC
$110.00Published rateRiverside Ambulatory Surgery Center LLC
$37.00Published rate
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See a sample payer proposalCPT 36430 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 36430 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 36430 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 36430. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 36430 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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