CPT 36456 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 • 23 - Emergency Room • 11 - Office |
| Common Modifiers | • None • RT - Right side of body • 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 36456 |
National average reimbursement for CPT 36456 by major payers:
$140.16
$145.62
$145.16
$179.34
| 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 36456 | ||||||
United | 36456 | $477.00 | 1477886406 - BILTMORE SURGICAL PARTNERS, LLC, DEER VALLEY SURGICAL AND ENDOSCOPY CENTER | 264509307 - (AZ) BILTMORE SURGICAL PARTNERS LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36456 | $175.00 | 1154046019 - GEORGIA INTERVENTIONAL PAIN | 880572909 - (GA) GEORGIA INTERVENTIONAL PAIN | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36456 | $64.00 | 1821093204 - LAUREL LASER & SURGERY CENTER, L.P. | 251852464 - (PA) LAUREL LASER SURGERY CENTER LP | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36456 | $100.00 | 1689188823 - FLORIDA ORTHOPAEDIC INSTITUTE SURGERY CENTER LLC | 823481913 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36456 | $110.00 | 1376729715 - ENDOSCOPY ASSOCIATES OF VALLEY FORGE, LLC | 161770779 - (PA) ENDOSCOPY ASSOCIATES OF VALLEY FORGE LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36456 | $191.00 | 1689910739 - THE ENDOSCOPY CENTER AT BAINBRIDGE, LLC, UNIVERSITY SUBURBAN ENDOSCOPY CENTER | 205430025 - (OH) THE ENDOSCOPY CENTER AT BAINBRIDGE LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36456 | $168.00 | 1538736459 - PONY CREEK ANNEX, LLC | 844833158 - (OR) PONY CREEK ANNEX LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36456 | $88.00 | 1245233410 - SURGICAL SPECIALTY CENTER OF NORTHEASTERN PENNSYLVANIA, LLC | 233022566 - (PA) SURGICAL SPECIALTY CENTER OF N | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36456 | $531.00 | 1841251501 - ST AUGUSTINE ENDOSCOPY CENTER LLC | 592947745 - (FL) ST AUGUSTINE ENDOSCOPY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36456 | $296.00 | 1922011501 - LOWERY A. WOODALL OUTPATIENT SURGERY FACILITY, LLC | 640897321 | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36456 | $681.00 | 1023071180 - SAHARA OUTPATIENT SURGERY CENTER LTD | 752509486 - (NV) SAHARA OUTPATIENT SURGERY CENTER LTD | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36456 | $206.00 | 1407801509 - ATLANTIC SURGERY CENTER,LLC | 223625894 - (NJ) ATLANTIC SURGERY CENTERLLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36456 | $2500.00 | 1528069218 - NORTHSHORE REGIONAL MEDICAL CENTER DBA THE SURGERY SUITE, THE SURGERY SUITE | 720502505 - (LA) OCHSNER CLINIC FOUNDATION | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36456 | $250.00 | 1952348013 - DAKOTA SURGERY & LASER CENTER LLC | 450448386 | ND | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36456 | $1551.00 | 1154454460 - TEXAS HEALTH HARRIS METHODIST HOSPITAL HURST-EULESS-BEDFORD | 751438726 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL HURST-EULESS-BEDFORD | TX | 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 36456 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 36456 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 36456 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 |
|---|---|---|
| 36456-CPT | Low | Partial Exchange Transfusion Blood Plasma Or Crystalloid Necessitating The Skill Of A Physician Or Other Qualified Health Care Professional Newborn |
| 36460-CPT | Moderate | Transfusion, Intrauterine, Fetal |
| 36500-CPT | Moderate | Catheterizat Vein Blood Sampling |
| 36511-CPT | Low | Therapeutic Apheresis; For White Blood Cells |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 36456. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 36456 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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