CPT 37160 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 | • 21 - Inpatient Hospital |
| Common Modifiers | • None • 58 - Staged or related procedure during postoperative period • GC - Service performed by resident under supervision • XU - Unusual Non-Overlapping Service • 53 - Discontinued procedure • 78 - Return to OR - related procedure |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 37160 |
National average reimbursement for CPT 37160 by major payers:

$2,571.33

$2,718.61

$3,042.88

$3,385.37
| 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 37160 | ||||||
United | 37160 | $306.00 | 1770551517 - SOUTHERN MARYLAND ENDOSCOPY CENTER | 522315798 - (MD) SOUTHERN MARYLAND ENDOSCOPY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37160 | $1200.00 | 1396832549 - GENESEE CARE L.L.C., THE SURGERY CENTER OF GENESEE COUNTY | 383242685 - (MI) GENESEE CARE LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37160 | $250.00 | 1306043617 - UROLOGY HEALTH SURGERY CENTER, LLC | 260412126 - (PA) UROLOGY HEALTH SURGERY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37160 | $326.00 | 1952408783 - SHADYSIDE SURGI-CENTER, INC. | 251707086 - (PA) SHADYSIDE SURGICENTER INC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37160 | $1227.00 | 1023182086 - EAST TEXAS MEDICAL CENTER CARTHAGE, ETMC CARTHAGE | 824037220 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37160 | $890.00 | 1003909789 - OREGON TRAIL EYE SURGERY CENTER, INC | 200121578 - (NE) OREGON TRAIL EYE SURGERY CENTER INC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37160 | $2847.00 | 1063720365 - WASATCH FRONT SURGERY CENTER LLC | 800612279 | UT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37160 | $544.00 | 1629145685 - IDAHO EYE CENTER PA, IDAHO EYE SURGICENTER | 820379995 - (ID) IDAHO EYE CENTER, P.A. | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37160 | $578.00 | 1891763157 - HOUMAS OUTPATIENT SURGERY CENTER | 721005613 - (LA) HOUMA OUTPATIENT SURGERY CENTER | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37160 | $486.00 | 1477513844 - SAINT CHARLES SURGICAL PAVILION INC | 352100103 - (IN) SAINT CHARLES SURGICAL PAVILION INC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37160 | $714.00 | 1972055382 - ALLIANCE SURGERY PARTNERS, LLC | 901108673 - (CA) ALLIANCE SURGERY PARTNERS LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37160 | $983.00 | 1356307565 - AMBULATORY SURGICAL ASSOCIATES LLC, TULLAHOMA SURGERY CENTER | 61658016 - (TN) AMBULATORY SURGICAL ASSOCIATES LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37160 | $860.00 | 1912909433 - CENTENNIAL SURGUNIT, LLC, CENTENNIAL SURGERY CENTER | 223580847 - (NJ) CENTENNIAL SURGUNIT LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37160 | $2652.00 | 1417534207 - MEDICAL CITY SURGERY CENTER OF FRISCO, LLC | 822432064 - (TX) MEDICAL CITY SURGERY CENTER OF FRISCO LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37160 | $2345.00 | 1720161615 - MANKATO SURGICAL CENTER, L.L.C., MANKATO SURGERY CENTER | 411924647 - (MN) MANKATO SURGICAL CENTER, LLC | MN | 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 37160 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 37160 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 37160 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 37160. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 37160 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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