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 |
National average reimbursement for CPT 36830 by major payers:
$947.53
$931.19
$973.52
$1,098.01
| 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 36830 | ||||||
United | 36830 | $6588.00 | 1356704027 - GLEN ECHO SURGERY CENTER, LLC | 474049838 - (MD) GLEN ECHO SURGERY CENTER LLC | MD | 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 | $3118.00 | 1447385158 - HARBIN CLINIC, LLC, HARBIN GI | 582234927 - (GA) THE HARBIN CLINIC, L.L.C. | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36830 | $7968.00 | 1164017778 - MEDICAL CITY SURGERY CENTER OF ALLIANCE, LLC | 822480225 - (TX) MEDICAL CITY SURGERY CENTER OF ALLIANCE LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36830 | $15758.92 | 1902920622 - WEST PENN ALLEGHENY HEALTH SYSTEM INC., ALLEGHENY GENERAL HOSPITAL | 250969492 - (PA) HIGHMARK HEALTH | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36830 | $2855.00 | 1801443320 - ST. LUKE'S SURGERY CENTER OF CHESTERFIELD, LLC | 384106846 - (MO) ST LUKES SURGERY CENTER OF CHESTERFIELD LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36830 | $3739.00 | 1437642857 - GEORGIA VASCULAR & VEIN CENTER | 822239594 - (GA) GEORGIA VASCULAR VEIN CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36830 | $2100.00 | 1659377042 - TOMS RIVER AMBULATORY SURGICAL CENTER, BEY LEA AMBULATORY SURGICAL CENTER | 223802381 - (NJ) TOMS RIVER AMBULATORY SURGICAL CENTER | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36830 | $3195.00 | 1538262118 - MERCURY SURGERY CENTER LLC | 202045960 - (MO) MERCURY SURGERY CENTER, LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36830 | $6429.00 | 1245529189 - CAPITOL SURGICAL CENTER LLC | 275067646 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36830 | $702.00 | 1851623961 - ALEXANDER EYE SURGERY CENTER, LLC | 271458954 | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36830 | $2633.00 | 1336112200 - MERCER COUNTY SURGERY CENTER LLC, MERCER COUNTY SURGERY CENTER | 223774069 - (NJ) MERCER COUNTY SURGERY CENTER, LLC | NJ | 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 | 1861411100 - WILLIAM TORTORIELLO | 350593390 - DEACONESS HOSPITAL INC | IN | Family Medicine Physician (207Q00000X) |
United | 36830 | $3400.00 | 1689736118 - VOA AMBULATORY SURGERY CENTER | 582351035 - (GA) VOA AMBULATORY SURGERY CENTER | 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 | 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 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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