CPT 36903 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-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 | • 24 - Ambulatory Surgical Center • 11 - Office |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | High |
National average reimbursement for CPT 36903 by major payers:
$5,359.60
$7,193.36
$6,861.39
$7,401.04
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
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CPT 36903 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 36903 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 36903 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 |
|---|---|---|
| 36901 | 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 | 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- |
| 36903 | 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 Transcatheter Placement Of |
| 36904 | High | Percutaneous Transluminal Mechanical Thrombectomy And/Or Infusion For Thrombolysis Dialysis Circuitany Method Including All Imaging And Radiologicalsupervision And Interpretation Diagnostic Angi- Ography Fluoroscopic Guidance Catheter Place- Ment(S) And Intraprocedural Pharmacological Throm-Bolytic Injection(S); |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 36903. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 36903 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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Medicare Reimbursement Lookup Tool
Medicare localities are geographic regions used to adjust reimbursement rates based on local costs. Rates vary by locality to reflect differences in wages, rent, and other expenses. Sign up to see commercial rates (United/BCBS/Cigna/Aetna)
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| Year | Billing Code | Locality | Non-Facility Fee | Facility Fee |
|---|