CPT 36831 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 • 78 - Return to OR - related procedure |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 36831 |
National average reimbursement for CPT 36831 by major payers:
$832.53
$781.46
$856.95
$952.59
| 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 36831 | ||||||
United | 36831 | $5500.00 | 1508169921 - SAINT LUKES-GI DIAGNOSTICS LLC | 274142549 - (MO) SAINT LUKESGI DIAGNOSTICS LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36831 | $7803.00 | 1447213954 - REAGAN STREET SURGERY CENTER, LLC | 201484668 - (CA) REAGAN STREET SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36831 | $1782.00 | 1629675285 - ORTHOARKANSAS SPINE INSTITUTE PROCEDURE CENTER LLC | 852741945 - (AR) ORTHOARKANSAS SPINE INSTITUTE PROCEDURE CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36831 | $1867.00 | 1639224827 - OAK SURGICAL INSTITUTE | 364337136 - (IL) OAK SURGICAL INSTITUTE | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36831 | $4170.00 | 1982880274 - BURLINGTON COUNTY ENDOSCOPY CENTER LLC | 208205206 - (NJ) BURLINGTON COUNTY ENDOSCOPY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36831 | $3439.00 | 1528196888 - NORTHWEST PLAZA ASC LLC | 205818059 - (GA) NORTHWEST PLAZA ASC LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36831 | $3029.00 | 1144970112 - SONORAN ENDOSCOPY CENTER LLC | 852760027 - (AZ) SONORAN ENDOSCOPY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36831 | $6087.00 | 1730318353 - GARDENDALE SURGICAL ASSOCIATES, LLC | 205936644 - (AL) GARDENDALE SURGICAL ASSOCIATES | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36831 | $1047.00 | 1346416690 - GARDEN STATE AMBULATORY SURGERY CENTER PC | 223504597 - (NJ) GARDEN STATE AMBULATORY SURGERY CENTER PC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36831 | $950.00 | 1275178444 - KENOSHA DIGESTIVE HEALTH CENTER LLC | 842167873 - (WI) KENOSHA DIGESTIVE HEALTH CENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36831 | $6492.00 | 1730369802 - SHORELINE SURGERY CENTER LLP, CHRISTUS SPOHN-SURGICARE OF CORPUS CHRISTI | 204911604 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36831 | $2121.00 | 1023071180 - SAHARA OUTPATIENT SURGERY CENTER LTD | 752509486 - (NV) SAHARA OUTPATIENT SURGERY CENTER LTD | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36831 | $3850.00 | 1669586376 - JEFFERSON AMBULATORY SURGERY CENTER LLC | 202349222 - (LA) JEFFERSON AMBULATORY SURGERY C | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36831 | $2373.00 | 1730410697 - SURGICAL SPECIALISTS AT PRINCETON LLC | 270749140 - (NJ) SURGICAL SPECIALISTS AT PRINCE | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36831 | $4234.00 | 1902218456 - TEXAS ENDOSCOPY CENTERS, LLC, TEXAS ENDOSCOPY AT INDEPENDENCE MEDICAL VILLAGE | 470985876 | TX | 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 36831 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 36831 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 36831 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 36831. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 36831 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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