CPT 36800 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 • 23 - Emergency Room |
| Common Modifiers | • None • 59 - Distinct Procedural Service • GC - Service performed by resident under supervision |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 36800 |
National average reimbursement for CPT 36800 by major payers:
$178.41
$186.68
$189.66
$218.63
| 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 36800 | ||||||
United | 36800 | $4611.00 | 1053059220 - CENTURION SURGERY CENTER OF JACKSONVILLE, LLC, CENTURION SURGERY CENTER OF JACKSONVILLE | 843958857 - (FL) CENTURION SURGERY CENTER OF JACKSONVILLE LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36800 | $5000.00 | 1245759356 - DALLAS ASC, LLC, NORTH PARK HEART & VASCULAR SURGERY CENTER | 823468320 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36800 | $2058.00 | 1982676227 - THE PALMETTO ASC, LLC, THE PALMETTO SURGERY CENTER | 621647406 - (FL) THE PALMETTO SURGERY CENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36800 | $1100.00 | 1003855594 - OHIO EYE ASSOCIATES, INC., OHIO EYE ASSOCIATES EYE SURGERY & LASER CENTER | 341171920 - (OH) OHIO EYE ASSOCIATES, INC. | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36800 | $2100.00 | 1043560295 - CENTENNIAL SPECIALTY SURGERY CENTER INC | 454699837 - (NV) CENTENNIAL SPECIALTY SURGERY CENTER INC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36800 | $3009.00 | 1427787142 - CAPITAL SURGERY CENTER LLC | 861660213 - (LA) CAPITAL SURGERY CENTER LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36800 | $1750.00 | 1548216914 - UPPER CUMBERLAND PHYSICIANS SURGERY CENTER LLC | 450470832 - (TN) UPPER CUMBERLAND PHYSICIANS SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36800 | $7695.00 | 1770847717 - ENDOSCOPY CENTER OF HACKENSACK, LLC, HACKENSACK ENDOSCOPY CENTER | 453948948 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36800 | $1782.00 | 1437110293 - ST. VINCENT-ARKANSAS ORTHOPAEDIC SURGERY CENTER LLC | 710813827 - (AR) ST VINCENTARKANSAS ORTHOPAEDIC SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36800 | $1680.00 | 1518279504 - EVANS PROCEDURE CENTER, LLC | 272289325 - (GA) EVANS PROCEDURE CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36800 | $1869.00 | 1871574145 - SURGERY CENTER AT REGENCY PARK, LLC | 311570817 - (OH) SURGERY CENTER AT REGENCY PARK, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36800 | $3375.00 | 1710112669 - NEWBRIDGE SURGERY CENTER AT WALDORF | 264650579 - (MD) NEWBRIDGE SURGERY CENTER AT WALDORF | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36800 | $1025.00 | 1992709851 - NOVAMED SURGERY CENTER OF CHICAGO-NORTHSHORE, LLC | 50540721 - (IL) NOVAMED SURGERY CENTER OF CHICAGONORTHSHORE LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36800 | $7326.00 | 1538316278 - PHYSICIANS' SURGERY CENTER OF DOWNEY, LLC | 205170962 - (CA) PHYSICIANS SURGERY CENTER OF | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36800 | $1315.00 | 1093974602 - EVERGREEN ENDOSCOPY CENTER, LLC | 412211130 - (CT) EVERGREEN ENDOSCOPY CENTER LLC | CT | 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 36800 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 36800 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 36800 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 36800. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 36800 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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