CPT 36478 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 |
National average reimbursement for CPT 36478 by major payers:
$1,331.89
$1,712.13
$1,685.67
$1,924.01
| 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 36478 | ||||||
United | 36478 | $3580.00 | 1033714001 - SURGERY CENTER AT SOUTH OGDEN, LLC | 854070407 - (UT) SURGERY CENTER AT SOUTH OGDEN LLC | UT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36478 | $2074.00 | 1275687873 - DERMATOLOGY ASSOCIATES OF KENTUCKY, PSC | 611262927 - (KY) NEW LEXINGTON CLINIC, P.S.C. | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36478 | $1632.00 | 1447991138 - SILVER STATE SURGERY CENTER WEST LLC | 872764352 - (NV) SILVER STATE SURGERY CENTER WEST LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36478 | $1910.00 | 1457725392 - THE ENDOSCOPY CENTER OF QUEENS INC | 262427823 - (NY) THE ENDOSCOPY CENTER OF QUEENS INC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36478 | $900.28 | 1770868606 - EMILY MURPHY | 350593390 - DEACONESS HOSPITAL INC | IN | Nurse Practitioner (363L00000X) |
United | 36478 | $1584.00 | 1558787614 - DIGESTIVE CARE ENDOSCOPY | 464923646 - (GA) DIGESTIVE CARE ENDOSCOPY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36478 | $1959.44 | 1962498741 - RUPINDER SANDHU | 350593390 - DEACONESS HOSPITAL INC | VA | Hospitalist Physician (208M00000X) |
United | 36478 | $1406.77 | 1396990701 - PEACEHEALTH, ST JOSEPH MEDICAL CENTER | 910565889 - PEACEHEALTH ST JOSEPH MEDICAL CENTER | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36478 | $900.28 | 1326280868 - CORIE AIKEN | 350593390 - DEACONESS HOSPITAL INC | IN | Nurse Practitioner (363L00000X) |
United | 36478 | $900.28 | 1609833169 - RANDALL KRAWCHECK | 350593390 - DEACONESS HOSPITAL INC | VA | Surgical Critical Care Physician (2086S0102X) |
United | 36478 | $3347.00 | 1881969269 - SURGERY CENTRE OF SW FLORIDA LLC, CAPE HEALTH SURGERY CENTER | 454068750 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36478 | $5390.00 | 1487933172 - MT. SCOTT SURGERY CENTER, LLC | 832600045 | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36478 | $2043.00 | 1437871373 - NORTHEAST INDIANA AMBULATORY SURGERY CENTER LLC | 830979985 - (IN) NORTHEAST INDIANA AMBULATORY SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36478 | $1879.00 | 1972831998 - SAN DIEGO SKIN, INC. | 203245033 - (CA) SAN DIEGO SKIN, INC M MARK MOFID MD APC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36478 | $1959.44 | 1619031416 - DEACONESS HOSPITAL, INC, <UNAVAIL> | 350593390 - DEACONESS HOSPITAL INC | IN | Anesthesiology Physician (207L00000X) |
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 36478 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 36478 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 36478 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 |
|---|---|---|
| 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 |
| 36478-CPT | High | Endovenous Ablation Therapy Of Incompetent Vein, Extremity Percutaneous Laser; 1st Vein Treated- Medicaid:Nr 12/8/07-11/29/2019; Commercial:Nr 12/8/07-12/31/14 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 36478. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 36478 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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