CPT 37223 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 • 22 - On Campus Outpatient Hospital • 11 - Office |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | High |
National average reimbursement for CPT 37223 by major payers:
$2,212.60
$3,041.68
$2,648.51
$2,706.41
| 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 37223 | ||||||
United | 37223 | $8535.00 | 1487012480 - LAKE SPIVEY AMBULATORY SURGERY CARE, LLC, SPIVEY STATION SURGERY CENTER | 582030692 - EMORY UNIVERSITY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37223 | $3800.00 | 1366643751 - SPECIALTY SURGICAL CENTER OF THOUSAND OAKS, L.P. | 205991988 - (CA) SPECIALTY SURGICAL CENTER OF THOUSAND OAKS, LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37223 | $2700.00 | 1578508875 - CLERMONT AMBULATORY SURGICAL CENTER | 202139893 - (FL) CLERMONT AMBULATORY SURGICAL CENTER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37223 | $3800.00 | 1255846762 - APEX AMBULATORY SURGERY CENTER INC | 820823327 - (CA) APEX AMBULATORY SURGERY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37223 | $6588.00 | 1265534556 - SOUTH FLORIDA AMBULATORY SURGICAL CENTER LLC | 651093026 - (FL) SOUTH FLORIDA AMBULATORY SURGI | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37223 | $7888.00 | 1245820042 - ALOE SURGICAL CENTER SCOTTSDALE, LLC | 845112576 - (AZ) ALOE SURGICAL CENTER SCOTTSDALE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37223 | $4240.00 | 1053585125 - BJOSC, LLC, BONE & JOINT SURGERY CENTER | 300391378 - BJOSC LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37223 | $6500.00 | 1093750903 - FRANKLIN SURGICAL CENTER, LLC | 203412606 - (NJ) FRANKLIN SURGICAL CENTER | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37223 | $1873.00 | 1417190935 - MID-FLORIDA ENDOSCOPY & SURGERY CENTER LLC | 263388221 - (FL) MID-FLORIDA ENDOSCOPY & SURGER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37223 | $4809.00 | 1154318103 - OPTUM CARE WASHINGTON PLLC, OPTUM - KEMP SURGERY CENTER | 910214500 - THE EVERETT CLINIC, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37223 | $3823.00 | 1306973235 - DIGESTIVE DISEASE & ENDOSCOPY CENTER, LLC, DIGESTIVE DISEASE & ENDOSCOPY CENTER, PLLC | 912065379 - (WA) DIGESTIVE DISEASE & ENDOSCOPY CENTER, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37223 | $1222.00 | 1912992900 - BOISE ENDOSCOPY CENTER, LLC, DBA MERIDIAN ENDOSCOPY CENTER | 820506078 - (ID) BOISE ENDOSCOPY CENTER LLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37223 | $4813.00 | 1477242154 - PLYMOUTH ORTHOPEDIC SURGERY CENTER LLC, PLYMOUTH ORTHOPEDIC SURGERY CENTER | 883632673 - (MN) PLYMOUTH ORTHOPEDIC SURGERY CENTER LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37223 | $7029.00 | 1659335438 - RESTON SURGERY CENTER, LP | 113654617 - (VA) RESTON SURGERY CENTER LP | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37223 | $1472.00 | 1851516728 - PHOENIX ENDOSCOPY LLC | 710940187 - (AZ) PHOENIX ENDOSCOPY LLC | AZ | 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 37223 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 37223 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 37223 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 |
|---|---|---|
| 37220-CPT | High | Revascularization, Endovascular, Open Or Percutaneous, Iliac Artery, Unilateral, Initial Vessel; With Transluminal Angioplasty |
| 37221-CPT | High | Revascularization, Endovascular, Open Or Percutaneous, Iliac Artery, Unilateral, Initial Vessel; With Transluminal Stent Placement(S), Includes Angioplasty Within The Same Vessel, When Performed |
| 37222-CPT | Moderate | Revascularization, Endovascular, Open Or Percutaneous, Iliac Artery, Each Additional Ipsilateral Iliac Vessel; With Transluminal Angioplasty (List Separately In Addition To Code For Primary Procedure) |
| 37223-CPT | High | Revascularization, Endovascular, Open Or Percutaneous, Iliac Artery, Each Additional Ipsilateral Iliac Vessel; With Transluminal Stent Placement(S), Includes Angioplasty Within The Same Vessel, When Performed (List Separately In Addition To Code For Primary Procedu |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 37223. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 37223 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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