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 |
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 | $906.00 | 1295776920 - ROSE AMBULATORY SURGERY CENTER LP | 200415436 - (CO) ROSE AMBULATORY SURGERY CENTER LP | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36456 | $131.00 | 1235788878 - INTEGRATED SURGICAL INSTITUTE, LLC | 834505309 - (PA) INTEGRATED SURGICAL INSTITUTE | PA | 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 | 36456 | $172.00 | 1508845942 - ENDOSCOPY CENTER OF KNOXVILLE LP, THE ENDOSCOPY CENTER WEST | 621512837 - (TN) ENDOSCOPY CENTER OF KNOXVILLE LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36456 | $75.00 | 1336324045 - MCCANDLESS ENDOSCOPY CENTER, LLC | 261284448 - (PA) MCCANDLESS ENDOSCOPY CENTER | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36456 | $88.00 | 1487608071 - SAN BERNARDINO EYE SURGERY CENTER, LLC, THE EYE SURGERY CENTER | 330991348 - SAN BERNARDINO EYE SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36456 | $100.00 | 1316484447 - CAPITAL CHILDREN'S HEALTHCARE | 812837189 - (MD) CAPITAL CHILDRENS HEALTHCARE | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36456 | $208.00 | 1346317039 - UNIVERSITY OF MIAMI, UMIAMI MEDICINE - OPHTHALMOLOGY (PALM BEACH BASCOM PALMER - ASC) | 592579938 - UNIVERSITY OF MIAMI | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36456 | $823.00 | 1124484019 - EDISON SURGERY CENTER LLC | 475016492 - (NJ) EDISON SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36456 | $721.00 | 1225064736 - NMC SURGERY CENTER, L.P., THE SURGERY CENTER OF NACOGDOCHES | 752793512 - (TX) NMC SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36456 | $106.00 | 1538110713 - CENTER FOR DIGESTIVE HEALTH LLC | 201606438 - (MS) CENTER FOR DIGESTIVE HEALTH LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36456 | $326.00 | 1538231956 - COASTAL MEDICAL CENTER LLC | 650956639 - (FL) COASTAL MEDICAL CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36456 | $120.00 | 1730570003 - SMART PAIN SURGERY CENTER AT GERMANTOWN, LLC, CLEARWAY SURGERY CENTER OF GERMANTOWN | 472908671 - (MD) SMART PAIN SURGERY CENTER AT GERMANTOWN LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36456 | $65.00 | 1144482753 - CLARKSVILLE EYE SURGERY CENTER | 261815638 - (TN) CLARKSVILLE EYE SURGERY CENTER | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36456 | $319.00 | 1770147217 - ANDOVER AMBULATORY SURGERY CENTER, LLC | 830649332 - (KS) ANDOVER AMBULATORY SURGERY CENTER LLC | KS | 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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