CPT 36835 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 24 - Ambulatory Surgical Center |
| Common Modifiers | None LT - Left side of body QX - Qualified nonphysician anesthetist service: With medical direction by a physician QY - Medical direction of one CRNA by an anesthesiologist 59 - Distinct Procedural Service 78 - Return to OR - related procedure |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 36835 |
| Medicaid Fee Schedule | View Medicaid rates for 36835 |
National average reimbursement for CPT 36835 by major payers:
$700.20
$659.34
$693.05
$778.60
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 36835 | $1172.00 | 1356429765 - ASC OF GEORGIA DERMATOLOGIC SURGERY, ASC OF BAUCOM & MINA DERM SURGERY | 550892029 - (GA) ASC OF GEORGIA DERMATOLOGIC SURGERY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36835 | $1642.00 | 1780322750 - QUEENSRIDGE SURGERY CENTER | 862358950 - (NV) QUEENSRIDGE SURGERY CENTER | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36835 | $900.00 | 1679539688 - NORTHERN ARIZONA EYE ASSOCIATES | 263664479 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36835 | $3794.00 | 1275886319 - SURGERY CENTER OF BAY AREA HOUSTON, LLC | 320383244 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36835 | $1980.00 | 1437794625 - VANCE THOMPSON VISION SURGERY CENTER BILLINGS, LLC | 455323939 | MT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36835 | $1561.00 | 1477513844 - SAINT CHARLES SURGICAL PAVILION INC | 352100103 - (IN) SAINT CHARLES SURGICAL PAVILION INC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36835 | $1469.00 | 1366484776 - DUTCHESS SURGICAL CENTER | 141803011 - (NY) DUTCHESS AMBULATORY SURGICAL CENTER | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36835 | $3188.00 | 1942264619 - METROPOLITAN MEDICAL PARTNERS LLC, SURGERY CENTER OF CHEVY CHASE | 522303928 - (MD) METROPOLITAN MEDICAL PARTNERS LL | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36835 | $2245.00 | 1366908469 - BRUNSWICK SURGERY CENTER LLC | 824022728 - (NC) BRUNSWICK SURGERY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36835 | $1332.00 | 1881094894 - CENTER FOR COLON AND DIGESTIVE DISEASES LLC | 465382670 - (SC) CENTER FOR COLON AND DIGESTIVE DISEASES LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36835 | $1379.00 | 1255390670 - CARROLL COUNTY EYE SURGERY CENTER, LLC | 50576667 - (MD) CARROLL COUNTY EYE SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36835 | $2115.00 | 1336254770 - EYE SURGERY CENTER OF THE DESERT | 330708059 - (CA) EYE SURGERY CENTER OF THE DESERT | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36835 | $1458.00 | 1023005600 - PSHS BETA PARTNERS LTD, THE GABLES SURGICAL CENTER | 650848650 - (FL) PSHS BETA PARTNERS LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36835 | $1098.00 | 1346878303 - HOT SPRINGS AMBULATORY SURGERY CENTER, LLC | 832533389 - (AR) HOT SPRINGS AMBULATORY SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36835 | $1110.00 | 1700856242 - SOUTHERN OHIO EYE SURGERY CENTER, LLC | 43700734 - (OH) SOUTHERN OHIO EYE SURGERY CENTER LLC | OH | 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 36835 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 36835 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 36835 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. |
| 36835-CPT | Moderate | Insert Support Device, Surgery To Insert A Shunt (Support Device) Within A Blood Vessel. The Shunt Most Often Is Used For Dialysis. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 36835. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 36835 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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