CPT 36830 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 21 - Inpatient Hospital |
| Common Modifiers | None LT - Left side of body RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 36830 |
| Medicaid Fee Schedule | View Medicaid rates for 36830 |
National average reimbursement for CPT 36830 by major payers:
$947.53
$931.19
$973.52
$1,072.08
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 36830 | $1977.00 | 1639176183 - BERKS CENTER FOR DIGESTIVE HEALTH, LP | 233068912 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36830 | $7888.00 | 1366406233 - MIDDLE TENNESSEE AMBULATORY SURGERY CENTER, L.P. | 621699667 - (TN) MIDDLE TENNESSEE AMBULATORY SURGERY CENTER LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36830 | $1149.52 | 1619912979 - PATRICIA COPLEY | 350593390 - DEACONESS HOSPITAL INC | TX | Pulmonary Disease Physician (207RP1001X) |
United | 36830 | $6588.00 | 1811001860 - THE OUTPATIENT CENTER, LLC, THE OUTPATIENT CENTER OF BOYNTON BEACH, LTD. | 650440864 - (FL) THE OUTPATIENT CENTER OF BOYNTON BEACH, LTD. | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36830 | $3757.00 | 1477586063 - ATHENS ORTHOPEDIC CLINIC AMBULATORY SURGERY CENTER, LLC | 203378059 - (GA) ATHENS ORTHOPEDIC CLINIC AMBULATORY SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36830 | $1035.00 | 1326340852 - THE SURGICAL INSTITUTE OF MONROE AMBULATORY SURGERY CENTER LLC, SURGICAL INSTITUTE OF MONROE | 270843485 - (MI) SURGICAL INSTITUTE OF MONROE | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36830 | $3489.00 | 1689133290 - MOHAWK SURGERY CENTER LLC | 830632231 - (FL) MOHAWK SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36830 | $6492.00 | 1881013142 - ADVANCED SURGERY CENTER OF TAMPA, LLC | 463891843 - (FL) ADVANCED SURGERY CENTER OF TAMPA, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36830 | $5465.00 | 1306833009 - SOUTH BROWARD ENDOSCOPY L L C | 113685842 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36830 | $4401.00 | 1235393356 - PHYSICIANS OUTPATIENT SURGERY CENTER LLC | 352325646 - (FL) PHYSICIANS OUTPATIENT SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36830 | $3109.00 | 1154867562 - UROLOGIC AMBULATORY SURGERY CENTER, LLC | 814904405 - (MS) UROLOGIC AMBULATORY SURGERY CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36830 | $2467.00 | 1285333914 - ARIZONA SURGICAL SPECIALISTS CENTER, LLC, ARIZONA SURGICAL SPECIALISTS CENTER, LLC - SCOTTSDALE | 760737449 - (AZ) ARIZONA SURGICAL SPECIALISTS CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36830 | $2500.00 | 1750884052 - PRECISION SURGERY CENTER PLLC | 824729968 - (ID) PRECISION SURGERY CENTER PLLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36830 | $3500.00 | 1437501145 - NORTH CARE ASC, LLC | 810851059 - (CO) NORTH CARE ASC LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36830 | $3200.00 | 1073556338 - VALDOSTA PODIATRY ASSOCIATES, PC, NORTH OAK AMBULATORY SURGERY CENTER | 261479859 | GA | 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 36830 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 36830 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 36830 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 | Blood Vessel Surgery, Surgery Using A Graft To Revise Or Reconstruct The Connection Between Two Blood Vessels (An Artery And Adjacent Vein). A Blood Clot May Be Removed At This Time As The Increased Blood Flow At The Connection Site (A-V Fistula) Is Ideal For Delivering Therapy. |
| 36830-CPT | Moderate | Blood Vessel Surgery, Surgery Using A Graft To Revise Or Reconstruct The Connection Between Two Blood Vessels (An Artery And Adjacent Vein). A Blood Clot May Be Removed At This Time As The Increased Blood Flow At The Connection Site (A-V Fistula) Is Ideal For Delivering Therapy. |
| 36831-CPT | Moderate | Removal Of Blood Clot, Removal Of A Blood Clot Through A Thin Tube (Catheter) Inserted Into An A-V Fistula (Connected Artery And Vein). The Clot Is Manually Removed Or A Clot-Busting Drug Is Delivered Through The Catheter. The Increased Blood Flow Makes It An Ideal Treatment Site. |
| 36832-CPT | Moderate | Blood Vessel Surgery, Surgery Using A Graft To Revise Or Reconstruct The Connection Between Two Blood Vessels (An Artery And Adjacent Vein). A Blood Clot May Be Removed At This Time As The Increased Blood Flow At The Connection Site (A-V Fistula) Is Ideal For Delivering Therapy. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 36830. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 36830 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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