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See a sample rate comparisonCPT 36516 Fee Schedule
Last Verified: October 2026
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.
Blood Component Removal, An Amount Of Blood Is Removed From The Body. It Is Filtered To Remove A Particular Component Such As White Or Red Cells Platelets Plasma Or Lipids. The Filtered Blood Is Then Returned To The Body.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Cardiovascular System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 11 - Office |
| Common Modifiers | GC - Service performed by resident under supervision AG - Primary physician |
| Complexity Level | High |
| Medicare Fee Schedule | $2,227.84 national non-facility rate (2026) · View Medicare rates for 36516 |
| Medicaid Fee Schedule | $1,793.605 median of the 8 states in the free preview · View Medicaid rates for 36516 |
National average reimbursement for CPT 36516 by major payers:
$2,266.13
$2,752.61
$2,748.86
$415.61
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CPT 36516
5 of 25 sample ratesHigher to lower in this preview
Deaconess Hospital, Inc, <Unavail>
Deaconess Hospital Inc
$11,927.00Published rateEnti Surgery Center LLC
$3,711.00Published rateAsc Development Company, LLC, National Spine And Pain Centers
Asc Development Company LLC
$2,693.00Published rateLisa Vellinga
Deaconess Hospital Inc
$1,583.52Published rateLocust Grove Endo Center
$390.00Published rate
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See a sample payer proposalCPT 36516 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 36516 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 36516 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 |
|---|---|---|
| 36511-CPT | Low | Blood Component Removal, An Amount Of Blood Is Removed From The Body. It Is Filtered To Remove A Particular Component Such As White Or Red Cells Platelets Plasma Or Lipids. The Filtered Blood Is Then Returned To The Body. |
| 36512-CPT | Low | Blood Component Removal, An Amount Of Blood Is Removed From The Body. It Is Filtered To Remove A Particular Component Such As White Or Red Cells Platelets Plasma Or Lipids. The Filtered Blood Is Then Returned To The Body. |
| 36513-CPT | Low | Blood Component Removal, An Amount Of Blood Is Removed From The Body. It Is Filtered To Remove A Particular Component Such As White Or Red Cells Platelets Plasma Or Lipids. The Filtered Blood Is Then Returned To The Body. |
| 36516-CPT | High | Blood Component Removal, An Amount Of Blood Is Removed From The Body. It Is Filtered To Remove A Particular Component Such As White Or Red Cells Platelets Plasma Or Lipids. The Filtered Blood Is Then Returned To The Body. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 36516. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 36516 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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