CPT 36557 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 | • 21 - Inpatient Hospital • 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 36557 |
National average reimbursement for CPT 36557 by major payers:
$1,238.79
$1,371.07
$1,627.97
$1,716.72
| 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 36557 | ||||||
United | 36557 | $5414.08 | 1609343052 - ADVANCED MEDICAL IMAGING SURGERY CENTER, LLC | 831444320 - (NE) ADVANCED MEDICAL IMAGING SURGERY CENTER LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36557 | $6492.00 | 1659517019 - SURGERY CENTER OF PEMBROKE PINES, LLC | 263364068 - (FL) SURGERY CENTER OF PEMBROKE | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36557 | $2854.00 | 1598339392 - COPPER CITY SURGERY CENTER, PLLC | 831039743 - (MT) COPPER CITY SURGERY CENTER PLLC | MT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36557 | $2665.00 | 1336562156 - RYE SURGICAL CENTER, LLC | 463464240 - (NH) RYE SURGICAL CENTER LLC | NH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36557 | $5105.00 | 1174708390 - ORTHOPAEDIC SPECIALTY SURGERY CENTER LLC, ORTHOPAEDIC & SPECIALTY SURGERY CENTER | 263119034 - (CT) ORTHOPAEDIC SPECIALTY SURGERY CENTER, LLC | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36557 | $5000.00 | 1356798854 - MID CITIES ASC, LP | 811663790 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36557 | $4121.00 | 1972114171 - SURGERY CENTER OF OAKLAND LP | 851685384 - (CA) SURGERY CENTER OF OAKLAND, LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36557 | $1064.00 | 1326089715 - SOUTHWESTERN EYE CENTER LTD, SOUTHWESTERN EYE CENTER | 860423068 - SOUTHWESTERN EYE CENTER, LTD. | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36557 | $6588.00 | 1750363461 - BARKLEY SURGICENTER, LLC | 650428622 - (FL) BARKLEY SURGICENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36557 | $1765.94 | 1710208178 - MICHAEL JOHNS | 350593390 - DEACONESS HOSPITAL INC | KY | Family Medicine Physician (207Q00000X) |
United | 36557 | $1926.00 | 1659679074 - EYE SURGERY CENTER OF MIDDLE TENNESSEE, LLC | 275124581 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36557 | $761.00 | 1619940582 - FT MYERS DIGESTIVE HEALTH AND PAIN ASC LLC, CENTER FOR DIGESTIVE HEALTH AND PAIN MANAGEMENT | 621848758 - (FL) FT MYERS DIGESTIVE HEALTH AND PAIN ASC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36557 | $9674.00 | 1528438884 - MCLEAN AMBULATORY SURGERY, LLC | 474966649 - (VA) MCLEAN AMBULATORY SURGERY LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36557 | $3000.00 | 1679595680 - SURGERY CENTER OF LEBANON, LP, PHYSICIANS SURGICAL CENTER | 721588584 - (PA) SURGERY CENTER OF LEBANON LP | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36557 | $1020.00 | 1205821097 - ADOBE SURGERY CENTER, PC | 860835901 - (AZ) ADOBE SURGERY CENTER PC | AZ | 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 36557 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 36557 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 36557 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 |
|---|---|---|
| 36481-CPT | High | Insertion Of Catheter Into Portal Vein Of Liver, Accessed Through The Skin |
| 36482-CPT | High | Endovenous Ablation Therapy Of Incompetent Vein Extremity By Transcatheter Delivery Of A Chemical Adhesive (Eg Cyanoacrylate) Remote From The Access Site Inclusive Of All Imaging Guidance And Monitoring Percutaneous; First Vein Treated |
| 36555-CPT | Moderate | Insertion Of Non-Tunneled Centrally Inserted Central Venous Catheter; Under 5 Years Of Age |
| 36557-CPT | High | Insertion Of Tunneled Centrally Inserted Central Venous Catheter, Without Subcutaneous Port Or Pump; Younger Than 5 Years Of Age |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 36557. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 36557 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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