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See a sample rate comparisonCPT 36861 Fee Schedule
Last Verified: October 2026
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.
External Cannula Declotting (S, External Cannula Declotting (Separate Procedure) Withballoon Catheter External Cannula Declotting (Separate Procedure) With
| 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 59 - Distinct Procedural Service UB 78 - Return to OR - related procedure |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 36861 |
| Medicaid Fee Schedule | View Medicaid rates for 36861 |
National average reimbursement for CPT 36861 by major payers:
$197.64
$198.87
$201.41
$229.14
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CPT 36861
5 of 25 sample ratesHigher to lower in this preview
Surgical Suites Of Coastal Virginia, LLC
Surgical Suites Of Coastal Virginia LLC
$11,344.00Published rateDay Surgery Limited Liability
Day Surgery LLC
$5,309.00Published rateEverest Asc
$4,037.00Published ratePhysicians Pavilion Lp, Physicians Pavilion Surgery Center
$3,042.00Published rateWellbrook Endoscopy Center, LLC
Wellbrook Endoscopy Center LLC
$891.00Published rate
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See a sample payer proposalCPT 36861 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 36861 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 36861 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 | External Cannula Declotting (S, External Cannula Declotting (Separate Procedure) Withoutballoon Catheter External Cannula Declotting (Separate Procedure) Without |
| 36861-CPT | Low | External Cannula Declotting (S, External Cannula Declotting (Separate Procedure) Withballoon Catheter External Cannula Declotting (Separate Procedure) With |
| 36901-CPT | Moderate | Intro Cath Dialysis Circuit, Introduction Of Needle S And Or Catheter S Dialysis Circuit With Diagnostic Angiography Of The Dialysis Circuit Including All Direct Puncture S And Catheter Placement S Injection S Of Contrast 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 Documentation And Report |
| 36902-CPT | High | Intro Cath Dialysis Circuit, Introduction Of Needle S And Or Catheter S Dialysis Circuit With Diagnostic Angiography Of The Dialysis Circuit Including All Direct Puncture S And Catheter Placement S Injection S Of Contrast 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 Documentation And Report With Transluminal Balloon Angioplasty Peripheral Dialysis Segment Including All Imaging And Radiological Supervision And Interpretation Necessary To Perform The Angioplasty |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 36861. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 36861 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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