CPT 36474 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 • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 36474 by major payers:
$305.74
$381.62
$386.72
$451.62
| 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 36474 | ||||||
United | 36474 | $560.00 | 1114264488 - EXECUTIVE SURGERY CENTER, LLC | 300701899 - (TX) EXECUTIVE SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36474 | $175.00 | 1275595746 - REGIONAL SURGICAL CENTRE, INC. | 640911313 - (MS) REGIONAL SURGICAL CENTRE INC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36474 | $1306.00 | 1164513149 - ENDO-SURGI OF UNION ASC LLC | 223248249 - (NJ) ENDO-SURGI CENTER, P.A. | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36474 | $170.00 | 1992708929 - NOVAMED MANAGEMENT SERVICES LLC, ATLANTA EYE SURGERY CENTER | 364013255 - NOVAMED, INC. | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36474 | $1029.00 | 1720020472 - DENTON SURGERY CENTER LLC, TEXAS HEALTH SURGERY CENTER DENTON | 470926556 - (TX) DENTON SURGERY CENTER, LLC DBA TEXAS HEALTH SURGERY CENTER DENTON | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36474 | $1250.00 | 1487012480 - LAKE SPIVEY AMBULATORY SURGERY CARE, LLC, SPIVEY STATION SURGERY CENTER | 582030692 - EMORY UNIVERSITY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36474 | $566.00 | 1801146535 - SURGCENTER AT PARADISE VALLEY, LLC, SURGCENTER AT PIMA CROSSING | 455364868 - (AZ) SURGCENTER AT PARADISE VALLEY | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36474 | $82.00 | 1528206141 - HATTIESBURG EYE CLINIC CATARACT & LASIK SURGERY CENTER, LLC | 200379151 - (MS) HATTIESBURG EYE CLINIC CATARACT LASIK SURGERY CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36474 | $225.00 | 1437615929 - BANNER ENTICARE TEMPE SURGERY CENTER LLC, BANNER TEMPE SURGERY CENTER | 833567835 - (AZ) BANNER ENTICARE TEMPE SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36474 | $225.00 | 1154911592 - BCC WEST VALLEY LLC | 854264663 - (AZ) BCC WEST VALLEY LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36474 | $44.00 | 1083654636 - PLASTIC SURGERY SPECIALISTS, PC, NORTH ARUNDEL PLASTIC SURGERY SPECIALISTS | 521357688 - (MD) PLASTIC SURGERY SPECIALISTS, P.C. | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36474 | $389.00 | 1639195217 - CY FAIR SURGERY CENTER | 760386971 - (TX) CY FAIR SURGERY CENTER | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36474 | $117.00 | 1659679074 - EYE SURGERY CENTER OF MIDDLE TENNESSEE, LLC | 275124581 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36474 | $150.00 | 1457674236 - CORM SURGICENTER | 260681153 - (TX) CORM SURGICENTER | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36474 | $1150.00 | 1598417875 - ESSENTIA HEALTH SURGERY CENTERS-DULUTH LLC, ESSENTIA HEALTH SURGERY CENTER-MILLER HILL | 874339770 - (MN) ESSENTIA HEALTH SURGERY CENTERSDULUTH LLC | MN | 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 36474 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 36474 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 36474 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 |
|---|---|---|
| 36466-CPT | High | Injection Of Non-Compounded Foam Sclerosant With Ultrasound Compression Maneuvers To Guide Dispersion Of The Injectate Inclusive Of All Imaging Guidance And Monitoring; Multiple Incompetent Truncal Veins (Eg Great Saphenous Vein Accessory Saphenous Vein) Same Leg |
| 36468-CPT | Moderate | Injection(S) Of Sclerosant Solutions For Spider Veins (Telangiectasia) Limb Or Trunk (Desc Revised 1/1/2018) |
| 36473-CPT | High | Once Per Dos Endovenous Ablation Therapy Of Incompetent Vein, Extremity, Incl All Imaging Guidance/Monitoring, Percutaneous-Deny Inv/N10>=1/30/2020 & 2/22/17-11/29/19 |
| 36474-CPT | Moderate | Endovenous Ablation Therapy Of Incompetent Extremity Inclusive Of All Imaging Guidan Monitoring Percutaneous Mechanochemical; Subsequent Vein(S) Treated In A Single Extremity Each Through Separate Access Sites (List Separate-Ly In Addition To Code For Primary Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 36474. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 36474 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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