CPT 36558 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 36558 by major payers:
$970.25
$1,095.79
$1,237.53
$1,293.23
| 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 36558 | ||||||
United | 36558 | $888.00 | 1215967351 - FRIENDSHIP AMBULATORY SURGERY CENTER, FRIENDSHIP AMBULATORY SURGERY CENTER | 521873474 - (MD) FRIENDSHIP AMBULATORY SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36558 | $1088.00 | 1528680865 - MERIDIAN SURGERY CENTER LLC | 845179604 - (MD) MERIDIAN SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36558 | $1500.00 | 1841672615 - ALLIANCE SURGERY CENTER AT AUGUSTA, LLC | 474382081 - (GA) ALLIANCE SURGERY CENTER AT AUGUSTA LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36558 | $1494.00 | 1427003904 - PHILADELPHIA WOMEN'S CENTER, INC. | 232476628 - (PA) PHILADELPHIA WOMENS CENTER INC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36558 | $1056.00 | 1073888103 - SURGERY BY VOLD VISION | 454504788 - (AR) SURGERY BY VOLD VISION | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36558 | $3500.00 | 1649223124 - CAMP LOWELL SURGERY CENTER,LLC, CAMP LOWELL SURGERY CENTER | 201086556 - (AZ) CAMP LOWELL SURGERY CENTER | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36558 | $2795.00 | 1144291261 - OCEAN SURGICAL PAVILION, PC, OCEAN SURGICAL PAVILION | 223182653 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36558 | $1890.00 | 1528553559 - SURGICAL PAIN CENTER OF THE ADIRONDACKS, LLC | 821943675 - (NY) SURGICAL PAIN CENTER OF THE ADIRONDACKS LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36558 | $2056.00 | 1407539539 - RSC SURGERY CENTER, LLC | 352345966 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36558 | $1044.00 | 1588879266 - BAYSIDE ENDOSCOPY CENTER LLC, EAST GREENWICH ENDOSCOPY CENTER | 200207545 - (RI) BAYSIDE ENDOSCOPY CENTER LLC | RI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36558 | $2096.00 | 1619970472 - CYPRESS OUTPATIENT SURGICAL CENTER, INC. | 770173551 - (CA) CYPRESS OUTPATIENT SURGICAL CENTER, INC. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36558 | $3500.00 | 1821421256 - MONOCACY SURGERY CENTER LLC | 462861862 - (MD) MONOCACY SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36558 | $1896.00 | 1699256404 - LEGACY SURGERY CENTER LLC | 831722822 - (FL) LEGACY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36558 | $1983.00 | 1962815746 - CAPITOL STREET SURGERY CENTER LLC | 465061657 - (IN) CAPITOL STREET SURGERY CENTER LL | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36558 | $2064.00 | 1912909433 - CENTENNIAL SURGUNIT, LLC, CENTENNIAL SURGERY CENTER | 223580847 - (NJ) CENTENNIAL SURGUNIT LLC | NJ | 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 36558 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 36558 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 36558 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 |
|---|---|---|
| 36522-CPT | High | Photopheresis, Extracorporeal - Rn Review=7/9/2011-2/19/2013:Elig Dx= 20210-20228, 2795x, 99685 Other Rn Review<7/9/2011 |
| 36555-CPT | Moderate | Insertion Of Non-Tunneled Centrally Inserted Central Venous Catheter; Under 5 Years Of Age |
| 36556-CPT | Moderate | Insertion Of Non-Tunneled Centrally Inserted Central Venous Catheter; Age 5 Years Or Older |
| 36558-CPT | Moderate | Insertion Of Tunneled Centrally Inserted Central Venous Catheter Without Subcutaneous Port Or Pump; Age 5 Years Or Older |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 36558. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 36558 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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