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 |
| Medicare Fee Schedule | View Medicare rates for 37223 |
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 | $1265.00 | 1902095417 - PERIMETER SURGICAL CENTER INC | 260698992 - (OH) PERIMETER SURGICAL CENTER INC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37223 | $12899.00 | 1396774543 - WISCONSIN SURGERY CENTER LLC | 383661215 - (WI) WISCONSIN SURGERY CENTER, LLC | WI | 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 | $1250.00 | 1649250218 - LORAIN SURGERY CENTER, LLC | 201641777 - (OH) LORAIN SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37223 | $3657.00 | 1013471754 - ADVANCED SURGERY CENTER OF LANCASTER, LLC | 831133719 - (PA) ADVANCED SURGERY CENTER OF LANCASTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37223 | $5694.00 | 1437250248 - GEORGIA SURGICAL CENTER ON PEACHTREE, LLC | 582394271 - (GA) GEORGIA SURGICAL CENTER ON PEACHTREE LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37223 | $2193.00 | 1790744175 - WESTERN WASHINGTON ENDOSCOPY CENTERS LLC, PUYALLUP ENDOSCOPY CENTER | 200289310 - (WA) WESTERN WASHINGTON ENDOSCOPY CENTERS LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37223 | $731.00 | 1548254402 - LIVE OAK ENDOSCOPY CENTER, LLC | 10709517 - (FL) LIVE OAK ENDOSCOPY CENTER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37223 | $2123.00 | 1013011162 - BAY AREA ENDOSCOPY CENTER LIMITED PARTNERSHIP | 593213374 - (FL) BAY AREA ENDOSCOPY CENTER LIMITED PARTNERSHIP | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37223 | $7630.00 | 1346624665 - WESTGREEN SURGICAL CENTER LLC, HOUSTON ORTHOPEDIC & SPINE SURGERY CENTER | 474468184 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37223 | $4445.00 | 1508942996 - PHYSICIANS SURGERY SERVICES LP, ADVANCED SURGERY CENTER | 201074818 - (CA) PHYSICIAN SURGERY SERVICES L.P. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37223 | $1540.00 | 1346596566 - SCP INDIANAPOLIS LLC | 460639908 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37223 | $8090.00 | 1023359627 - THE EMORY CLINIC INC., EMORY AESTHETIC CENTER | 582030692 - EMORY UNIVERSITY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37223 | $980.00 | 1881875227 - SKIN & MOHS SURGERY CENTER, LLC | 431823843 - SKIN MOHS SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37223 | $6000.00 | 1780331769 - ASC SURGICAL VENTURES, LLC | 351995261 | IN | 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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