CPT 36860 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 • 59 - Distinct Procedural Service • 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 36860 |
National average reimbursement for CPT 36860 by major payers:
$263.49
$297.88
$319.96
$368.06
| 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 36860 | ||||||
United | 36860 | $600.00 | 1689173981 - MAO LEAWOOD SURGERY CENTER LLC | 812903525 - (KS) MAO LEAWOOD SURGERY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36860 | $966.00 | 1396011615 - MEC ENDOSCOPY LLC | 900768532 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36860 | $637.00 | 1407869373 - VALENCIA ASC, LLC, VALENCIA SUGICAL CENTER | 954879092 - (CA) VALENCIA OUTPATIENT SURGICAL | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36860 | $325.00 | 1578094462 - AMERICAN ACCESS CARE OF JACKSONVILLE ASC LLC, AZURA SURGERY CENTER JACKSONVILLE | 814635841 - (FL) AMERICAN ACCESS CARE OF JACKSONVILLE ASC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36860 | $436.00 | 1407188659 - LIMESTONE SURGERY CENTER LLC | 271490855 - (GA) LIMESTONE SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36860 | $603.00 | 1598744732 - MIDWEST EYE SURGERY CENTER, LLC | 470831193 - (NE) MIDWEST EYE SURGERY CENTER LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36860 | $1283.00 | 1861743601 - FLUSHING ENDOSCOPY CENTER, LLC | 274675522 - (NY) FLUSHING ENDOSCOPY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36860 | $432.89 | 1962784165 - RANA BEG | 350593390 - DEACONESS HOSPITAL INC | FL | Hospitalist Physician (208M00000X) |
United | 36860 | $953.00 | 1144954165 - ADVANCED SURGICAL CARE OF LUTZ, LLC, ADVANCED SURGICAL CARE OF NEW TAMPA | 871390521 - (FL) ADVANCED SURGICAL CARE OF LUTZ LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36860 | $315.00 | 1376580498 - SAME DAY SURGERY CENTERS OF FLORIDA LLC, SAME DAY SURGERY CENTER | 201804147 - (FL) SAME DAY SURGERY CENTERS OF FLORIDA LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36860 | $410.00 | 1164986683 - PROFFER SURGICAL CENTER, PLLC | 823343890 - (TX) PROFFER SURGICAL CENTER PLLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36860 | $1675.00 | 1427166990 - LOS ALTOS SURGERY CENTER LLC | 200864086 - (CA) LOS ALTOS | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36860 | $387.00 | 1073675583 - ROCKVILLE ESC NORTH MD ENDOSCOPY ASC LLC, ENDOSCOPIC SURGICAL CENTRE OF MARYLAND | 208004241 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36860 | $2307.00 | 1568410926 - MERIDIAN MEDICAL GROUP PC, MERIDIAN ENDOSCOPY CENTER | 208398421 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36860 | $560.00 | 1396709077 - RMC SURGERY CENTER, LLC, RMC SURGERY CENTER | 330937423 | CA | 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 36860 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 36860 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 36860 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 |
|---|---|---|
| 36860-CPT | Moderate | Cannula Declotting;W/O Balloon Cath |
| 36861-CPT | Low | Cannula Declotting; With Balloon Cathete |
| 36901-CPT | Moderate | Introduction Of Needle(S) And/Or Catheter(S) Di- Alysis Circuit With Diagnostic Angiography Of Thedialysis Circuit Including All Direct Puncture(S)And Catheter Placement(S) Injection(S) Of Con- Trast All Necessary Imaging From The Arterial Anastomosis And Adjacent Artery Through Entire Venous Outflow Including The Inferior Or Superior Vena Cava Fluoroscopic Guidance Radiological Supervision And Interpretation And Image Documen- Tation And Report; |
| 36902-CPT | High | Introduction Of Needle(S) And/Or Catheter(S) Di- Alysis Circuit With Diagnostic Angiography Of Thedialysis Circuit Including All Direct Puncture(S)And Catheter Placement(S) Injection(S) Of Con- Trast All Necessary Imaging From The Arterial Anastomosis And Adjacent Artery Through Entire Venous Outflow Including The Inferior Or Superior Vena Cava Fluoroscopic Guidance Radiological Supervision And Interpretation And Image Documen- Tation And Report; With Transluminal Balloon Angi- |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 36860. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 36860 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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