CPT 36475 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-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 • RT - Right side of body • LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 36475 |
National average reimbursement for CPT 36475 by major payers:
$1,472.52
$2,097.38
$1,928.76
$2,230.96
| 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 36475 | ||||||
United | 36475 | $1261.92 | 1053554121 - JONATHAN KATZ | 223636986 - BON SECOURS CHARITY HEALTH SYSTEM INC | NY | Cardiovascular Disease Physician (207RC0000X) |
United | 36475 | $1329.39 | 1063875763 - MARK DIIULIO | 854080775 - BRADFORD RADIOLOGY PC | NY | Vascular & Interventional Radiology Physician (2085R0204X) |
United | 36475 | $1401.48 | 1710219662 - VENTURA EYE INSTITUTE, INC | 271403188 | CA | Specialist (174400000X) |
United | 36475 | $7106.08 | 1770529083 - CHARLES LOWENSTEIN | 520595110 - JOHNS HOPKINS UNIVERSITY | MD | Cardiovascular Disease Physician (207RC0000X) |
United | 36475 | $3047.89 | 1053322198 - ROMAN ROYZMAN | 453023019 - NORTH SHORE-LIJ MEDICAL PC | NY | Cardiovascular Disease Physician (207RC0000X) |
United | 36475 | $1182.59 | 1386286581 - ALERACARE MEDICAL GROUP OF CALIFORNIA, ALERACARE MEDICAL GROUP OF CALIFORNIA | 843136867 | CA | Multi-Specialty Clinic/Center (261QM1300X) |
United | 36475 | $6333.43 | 1457593980 - SUTTER VALLEY MEDICAL FOUNDATION, SUTTER NORTH SURGERY CENTER | 680273974 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36475 | $9480.08 | 1184883738 - GINA CHOI | 954546865 | CA | Gastroenterology Physician (207RG0100X) |
United | 36475 | $6263.00 | 1699855213 - SANTA MONICA SURGICAL PARTNERS LLC, SURGERY CENTER OF THE PACIFIC | 870760381 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36475 | $1315.70 | 1821037698 - ALEXANDER MELMAN | 112232585 - ISLAND SURGICAL AND VASCULAR GROUP, P.C. | NY | Surgery Physician (208600000X) |
United | 36475 | $3597.88 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | 36475 | $1987.98 | 1386721033 - JOHN BUTTARI | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Physical Therapist (225100000X) |
United | 36475 | $640.42 | 1811000177 - CHARLESTON RADIOLOGISTS PA | 570634747 - CHARLESTON RADIOLOGISTS, P.A. | SC | Single Specialty Group (193400000X) |
United | 36475 | $1475.96 | 1770747123 - JUSTIN RATCLIFFE | 133515505 | NY | Interventional Cardiology Physician (207RI0011X) |
United | 36475 | $1822.78 | 1982660080 - STACIE BENNETT | 202949940 | CA | Specialist (174400000X) |
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 36475 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 36475 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 36475 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 |
|---|---|---|
| 36471-CPT | Moderate | Injection Of Sclerosant; Multiple Incompotent Veins (Other Than Telangiectasia) Same Leg (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) |
| 36475-CPT | High | Endovenous Ablation Therapy Of Incompetent Vein, Extremity, Inclusive Of All Imaging Guidance And Monitoring, Percutaneous, Radiofrequency; First Vein Treated |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 36475. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 36475 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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