CPT 36909 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 | 11 - Office 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | None LT - Left side of body 78 - Return to OR - related procedure |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 36909 |
| Medicaid Fee Schedule | View Medicaid rates for 36909 |
National average reimbursement for CPT 36909 by major payers:
$2,148.00
$2,673.59
$2,767.38
$482.87
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 36909 | $200.00 | 1023151974 - DEL MAR SURGERY CENTER | 330869192 - (CA) DEL MAR SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36909 | $1547.93 | 1538346200 - IRTAZA KHAN | 350593390 - DEACONESS HOSPITAL INC | IL | Critical Care Medicine (Internal Medicine) Physician (207RC0200X) |
United | 36909 | $1547.93 | 1649606815 - AMANDA ROMERHAUSEN | 350593390 - DEACONESS HOSPITAL INC | IN | Acute Care Nurse Practitioner (363LA2100X) |
United | 36909 | $477.00 | 1477886406 - BILTMORE SURGICAL PARTNERS, LLC, DEER VALLEY SURGICAL AND ENDOSCOPY CENTER | 264509307 - (AZ) BILTMORE SURGICAL PARTNERS LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36909 | $472.00 | 1972541415 - OCEAN ENDOSURGERY CENTER LLC, OCEAN ENDOSURGERY CENTER | 223564617 - (NJ) OCEAN ENDOSURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36909 | $688.00 | 1629386784 - ODESSA ENDOSCOPY CENTER LLC | 273305505 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36909 | $373.00 | 1871033878 - REDMOND AMBULATORY SURGERY CENTER, LLC | 813558711 - (WA) REDMOND AMBULATORY SURGERY CENTER LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36909 | $110.00 | 1205800752 - MEDICAL EYE ASSOCIATES, INC. | 581606296 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36909 | $4613.00 | 1245287697 - EAGLE HIGHLANDS SURGERY CENTER LLC, EAGLE HIGHLANDS SURGERY CENTER | 352072586 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36909 | $719.00 | 1306833009 - SOUTH BROWARD ENDOSCOPY L L C | 113685842 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36909 | $1665.00 | 1346235058 - EAST MEQUON SURGERY CENTER LLC | 861075286 - (WI) EAST MEQUON SURGERY CENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36909 | $342.00 | 1508135658 - SURGERY CENTER OF ATHENS LLC | 450581955 - (GA) SURGERY CENTER OF ATHENS LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36909 | $2438.00 | 1871720540 - BALL OUTPATIENT SURGERY CENTER, LLC, BALL OUTPATIENT SURGERY CENTER | 270275794 - (IN) BALL OUTPATIENT SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36909 | $506.00 | 1104189042 - FOOTHILLS SURGERY CENTER, LLC | 455328252 - (CO) FOOTHILLS SURGERY CENTER, LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 36909 | $150.00 | 1033375399 - ABILENE SURGERY CENTER, LLC | 208816729 - (TX) ABILENE SURGERY CENTER LLC | 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 36909 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 36909 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 36909 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 |
|---|---|---|
| 36904-CPT | High | Thrmbc Nfs Dialysis Circuit, Percutaneous Transluminal Mechanical Thrombectomy And Or Infusion For Thrombolysis Dialysis Circuit Any Method Including All Imaging And Radiological Supervision And Interpretation Diagnostic Angiography Fluoroscopic Guidance Catheter Placement S And Intraprocedural Pharmacological Thrombolytic Injection S |
| 36905-CPT | High | Thrmbc Nfs Dialysis Circuit, Percutaneous Transluminal Mechanical Thrombectomy And Or Infusion For Thrombolysis Dialysis Circuit Any Method Including All Imaging And Radiological Supervision And Interpretation Diagnostic Angiography Fluoroscopic Guidance Catheter Placement S And Intraprocedural Pharmacological Thrombolytic Injection S With Transluminal Balloon Angioplasty Peripheral Dialysis Segment Including All Imaging And Radiological Supervision And Interpretation Necessary To Perform The Angioplasty |
| 36906-CPT | High | Thrmbc Nfs Dialysis Circuit, Percutaneous Transluminal Mechanical Thrombectomy And Or Infusion For Thrombolysis Dialysis Circuit Any Method Including All Imaging And Radiological Supervision And Interpretation Diagnostic Angiography Fluoroscopic Guidance Catheter Placement S And Intraprocedural Pharmacological Thrombolytic Injection S With Transcatheter Placement Of Intravascular Stent S Peripheral Dialysis Segment Including All Imaging And Radiological Supervision And Interpretation Necessary To Perform The Stenting And All Angioplasty Within The Peripheral Dialysis Circuit |
| 36909-CPT | High | Dialysis Circuit Embolj, Dialysis Circuit Permanent Vascular Embolization Or Occlusion Including Main Circuit Or Any Accessory Veins Endovascular Including All Imaging And Radiological Supervision And Interpretation Necessary To Complete The Intervention List Separately In Addition To Code For Primary Procedure |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 36909. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 36909 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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