CPT 36825 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 | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 36825 |
National average reimbursement for CPT 36825 by major payers:
$1,029.05
$1,047.64
$1,156.65
$1,263.88
| 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 36825 | ||||||
United | 36825 | $946.00 | 1871531244 - NORTH HOUSTON ENDOSCOPY & SURGERY | 760688879 - (TX) NORTH HOUSTON ENDOSCOPY SURGERY | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36825 | $665.00 | 1659343648 - SWAGEL-WOOTTON EYE CENTER, INC, EYE SURGERY CENTER OF ARIZONA | 860555229 - (AZ) SWAGEL/WOOTTON EYE CENTER, LTD. | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36825 | $1350.00 | 1770599136 - RADIANCE-A PRIVATE OUTPATIENT SURGERY CENTER LLC, RADIANCE SURGERY CENTER | 510465402 - (PA) RADIANCE, LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36825 | $6492.00 | 1942715826 - SAFETY HARBOR ASC COMPANY LLC, SAFETY HARBOR SURGERY CENTER | 320547161 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36825 | $6588.00 | 1861740508 - ADVANCED SURGERY CENTER OF SARASOTA, LLC | 454909647 - (FL) ADVANCED SURGERY CENTER OF SARASOTA LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36825 | $6588.00 | 1467796730 - WINDSOR MILL SURGERY CENTER, LLC | 461412275 - (MD) WINDSOR MILL SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36825 | $5484.00 | 1205875283 - RWJ ENDOSURGICAL CENTER LLC | 900872940 - (NJ) RWJ ENDOSURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36825 | $920.00 | 1205800752 - MEDICAL EYE ASSOCIATES, INC. | 581606296 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36825 | $6500.00 | 1093750903 - FRANKLIN SURGICAL CENTER, LLC | 203412606 - (NJ) FRANKLIN SURGICAL CENTER | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36825 | $6914.00 | 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 | 36825 | $7229.00 | 1528210770 - SOUTH COUNTY OUTPATIENT ENDOSCOPY SERVICES, LP, SCOPES ENDOSCOPY CENTER | 263374547 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36825 | $4189.00 | 1871052712 - KURESMART PAIN MANAGEMENT SURGERY CENTER-COLUMBIA LLC, CLEARWAY SURGERY CENTER OF COLUMBIA | 834028893 - (MD) KURESMART PAIN MANAGEMENT SURGERY CENTERCOLUMBIA LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36825 | $3439.00 | 1881845907 - NORTH PACIFIC DERMATOLOGY PS | 204269950 - (WA) NORTH PACIFIC DERMATOLOGY PS | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36825 | $2405.00 | 1063416998 - WILMINGTON SURGERY CENTER, LP, WILMINGTON SURGCARE | 621775670 - (NC) WILMINGTON SURGERY CENTER LP | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36825 | $4189.00 | 1649735861 - KURESMART PAIN MANAGEMENT SURGERY CENTER-CATONSVILLE LLC, CLEARWAY SURGERY CENTER OF CATONSVILLE | 832414671 - (MD) KURESMART PAIN MANAGEMENT SURGERY CENTERCATONSVILLE LLC | MD | 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 36825 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 36825 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 36825 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 |
|---|---|---|
| 36825-CPT | High | Create Arterioven.Fist;Autogen.Gft |
| 36830-CPT | Moderate | Creation Of Arteriovenous Fistula By Other Than Direct Arteriovenous Anastomosis (Separate Procedure); Nonautogenous Graft (Eg Biological Collagen Thermoplastic Graft) (Desc Rev 1/1/03) |
| 36831-CPT | Moderate | Thrombectomy, Open, Arteriovenous Fistula Without Revision, Autogenous Or Nonautogenous Dialysis Graft (Separate Procedure) |
| 36832-CPT | Moderate | Revision, Open, Arteriovenous Fistula; Without Thrombectomy, Autogenous Or Nonautogenous Dialysis Graft (Separate Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 36825. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 36825 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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