CPT 36821 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 | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 36821 by major payers:
$831.27
$902.01
$985.26
$1,071.07
| 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 36821 | ||||||
United | 36821 | $5807.00 | 1164056974 - ORTHOPEDIC SURGERY CENTER OF THE FOX VALLEY LLC | 842016212 - (WI) ORTHOPEDIC SURGERY CENTER OF THE FOX VALLEY | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36821 | $2400.00 | 1144673526 - MURRIETA VALLEY SURGERY CENTER, INC.A PROFESSIONAL CORPORATION | 813020819 - (CA) MURRIETA VALLEY SURGERY CENTER INCA PROFESSIONAL CORPORATION | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36821 | $1155.00 | 1659363844 - LASER & SURGERY CENTER OF ACADIANA | 721288671 - (LA) LASER SURGERY CENTER OF ACADIANA | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36821 | $1300.00 | 1487657862 - FILLMORE EYE CLINIC INCORPORATED, FILLMORE EYE CLINIC ASC | 272444464 - (NM) FILLMORE EYE CLINIC, INC. | NM | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36821 | $3347.00 | 1558879684 - DELAWARE RIVER SURGICAL SUITES, LLC | 822713553 - (PA) BUCKS COUNTY SURGICAL SUITES | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36821 | $4994.00 | 1336148360 - BOULDER COMMUNITY MUSCULOSKELETAL SURGERY CENTER, LLC, BOULDER SURGERY CENTER | 201391702 - (CO) BOULDER COMMUNITY MUSCULOSKELETAL SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36821 | $1409.00 | 1619013455 - RUSH SURGICENTER AT THE PROFESSIONAL BUILDING LTD. PARTNERSHIP, RUSH SURGICENTER LTD. PARTNERSHIP | 363853026 - (IL) RUSH SURGICENTER, LTD. | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36821 | $525.78 | 1386650927 - BETHANY BURKHART-EDELEN | 350593390 - DEACONESS HOSPITAL INC | KY | Emergency Medicine Physician (207P00000X) |
United | 36821 | $525.78 | 1144845868 - LAURA KIRK | 350593390 - DEACONESS HOSPITAL INC | KY | Physician Assistant (363A00000X) |
United | 36821 | $2493.00 | 1346621893 - NORTHERN NEW JERSEY CENTER FOR ADVANCED ENDOSCOPY LLC | 472128570 - (NJ) NORTHERN NEW JERSEY CENTER FOR ADVANCED ENDOSCOPY LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36821 | $1783.00 | 1427005313 - WESTERN WASHINGTON MEDICAL GROUP, INC PS, WESTERN WASHINGTON MEDICAL GROUP ENDOSCOPY CENTER | 911602128 - (WA) WESTERN WASHINGTON MEDICAL GROUP, INC., P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36821 | $2050.00 | 1154034429 - CROSSINGS SURGERY CENTER, LLC | 881346867 - (RI) CROSSINGS SURGERY CENTER LLC | RI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36821 | $1549.00 | 1245471788 - PACIFIC CATARACT AND LASER INSTITUTE, INC., P.C. | 911394965 - PACIFIC CATARACT AND LASER INSTITUTE, INC., PC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36821 | $2500.00 | 1407305063 - GASTROENTEROLOGY OF WESTCHESTER, LLC, GASTROENTEROLOGY OF WESTCHESTER, LLC | 821095121 - (NY) GASTROENTEROLOGY OF WESTCHESTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36821 | $3157.00 | 1245239656 - SURGERY CENTER OF GILBERT LLC, SURGERY CENTER OF GILBERT | 731596190 - (AZ) SURGERY CENTER OF GILBERT, LLC | 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 36821 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 36821 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 36821 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 |
|---|---|---|
| 36821-CPT | Moderate | Arterioven.Anastomosis,Open,Any Site |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 36821. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 36821 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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