CPT 36560 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 36560 |
National average reimbursement for CPT 36560 by major payers:
$1,452.09
$1,721.53
$1,873.70
$1,968.55
| 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 36560 | ||||||
United | 36560 | $9098.00 | 1154454460 - TEXAS HEALTH HARRIS METHODIST HOSPITAL HURST-EULESS-BEDFORD | 751438726 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL HURST-EULESS-BEDFORD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36560 | $4600.00 | 1487371431 - BAYLOR SCOTT & WHITE SURGICARE WAXAHACHIE LLC | 920758698 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36560 | $2267.00 | 1083114995 - SURGERY CENTER OF LAWRENCEVILLE | 823510956 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36560 | $6342.00 | 1235752643 - TEXAS HEALTH SURGERY CENTER SOUTHWEST FORT WORTH, LLC | 843814490 - (TX) TEXAS HEALTH SURGERY CENTER SOUTHWEST FORT WORTH LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36560 | $768.00 | 1407992878 - WILSON COUNTY EYE SURGERY CENTER, LLC | 621714950 - (TN) WILSON COUNTY EYE SURGERY CENTER, LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36560 | $550.00 | 1679570774 - NOVAMED SURGERY CENTER OF MADISON, LIMITED PARTNERSHIP | 201915800 - (WI) NOVAMED SURGERY CENTER OF MADISON LIMITED PARTNERSHIP | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36560 | $4339.00 | 1891253035 - ADVANCED CENTER FOR SURGERY, THE ADVANCED CENTER FOR SURGERY | 611917634 - (FL) ADVANCED CENTER FOR SURGERY | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36560 | $2117.00 | 1275376121 - CLEARWAY SURGERY CENTER OF NATIONAL HARBOR LLC | 454110190 - (MD) HARBORSIDE SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36560 | $3014.00 | 1538189907 - INDEPENDENT PRACTIONERS OF AMERICA, LLC | 450455462 - (ND) INDEPENDENT PRACTITIONERS OF AMERICA, LLC | ND | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36560 | $7818.00 | 1619031416 - DEACONESS HOSPITAL, INC, <UNAVAIL> | 350593390 - DEACONESS HOSPITAL INC | IN | Anesthesiology Physician (207L00000X) |
United | 36560 | $2256.30 | 1558504506 - RIAD LUTFI | 350593390 - DEACONESS HOSPITAL INC | IN | Pediatric Critical Care Medicine Physician (2080P0203X) |
United | 36560 | $1410.00 | 1871260224 - BARNET DULANEY PERKINS EYE CENTER, PC, VALLEY OUTPATIENT SURGERY CENTER | 562589722 - BARNET DULANEY PERKINS EYE CENTER PLLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36560 | $2703.00 | 1962431197 - SHAWNEE MISSION SURGERY CENTER LLC, ADVENTHEALTH SURGERY CENTER SHAWNEE MISSION | 481243914 - (KS) SHAWNEE MISSION SURGERY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36560 | $1900.00 | 1710203427 - HARLINGEN SURGICAL CENTER, LLC, VALLEY EYE SURGERY CENTER | 270561821 - (TX) HARLINGEN SURGICAL CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36560 | $3500.00 | 1487620043 - NEW HORIZONS SURGERY CENTER LLC | 731572167 - (OH) NEW HORIZONS SURGERY CENTER LLC | OH | 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 36560 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 36560 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 36560 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 | Therapeutic Apheresis; For White Blood Cells |
| 36556-CPT | Moderate | Insertion Of Non-Tunneled Centrally Inserted Central Venous Catheter; Age 5 Years Or Older |
| 36557-CPT | High | Insertion Of Tunneled Centrally Inserted Central Venous Catheter, Without Subcutaneous Port Or Pump; Younger Than 5 Years Of Age |
| 36560-CPT | High | Insertion Of Tunneled Centrally Inserted Central Venous Access Device, With Subcutaneous Port; 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 36560. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 36560 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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