CPT 37228 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 37228 |
National average reimbursement for CPT 37228 by major payers:
$5,221.30
$7,077.79
$6,975.87
$7,277.93
| 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 37228 | ||||||
United | 37228 | $6046.00 | 1629703236 - NORTH CYPRESS SURGICENTER, LLC, NORTH CYPRESS SURGERY CENTER | 851383722 - (TX) NORTH CYPRESS SURGICENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37228 | $6492.00 | 1104298009 - RED CEDAR SURGERY CENTER, LLC, RED CEDAR SURGERY CENTER, PLLC | 472947364 - (MI) RED CEDAR SURGERY CENTER, PLLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37228 | $1163.00 | 1710047188 - ARROWHEAD ENDOSCOPY AND PAIN MANAGEMENT CENTER LLC, ARROWHEAD ENDOSCOPY CENTER. | 205706445 - (AZ) ARROWHEAD ENDOSCOPY AND PAIN MAN | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37228 | $1040.00 | 1518052380 - CUKROWSKI SURGERY CENTER PC, EAST MICHIGAN SURGERY CENTER | 203478646 - (MI) CUKROWSKI EYE CENTER PC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37228 | $1941.00 | 1265455463 - THE ENDOSCOPY CENTER AT BEL AIR | 470863243 - (MD) THE ENDOSCOPY CENTER AT BEL AIR | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37228 | $8024.00 | 1740328947 - ENDOSCOPY CONSULTANTS, LLC | 510425612 - (GA) ENDOSCOPY CONSULTANTS LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37228 | $4493.00 | 1194083824 - PROVIDENCE FACEY MEDICAL FOUNDATION, FACEY ENDOSCOPY CENTER | 954322584 - (CA) PROVIDENCE FACEY MEDICAL FOUNDATION | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37228 | $2460.00 | 1952868622 - YORK ENDOSCOPY CENTER LLC | 833765021 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37228 | $819.00 | 1134183056 - TOPEKA SURGERY CENTER | 364500418 | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37228 | $3700.00 | 1639668080 - ZAZEN SURGERY CENTER, LLC | 823788213 - (TX) ZAZEN SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37228 | $1466.00 | 1942485305 - 9106 PHILADELPHIA ROAD AMBULATORY SURGERY CENTER LLC | 261539834 - (MD) 9106 PHILADELPHIA ROAD AMBULATORY SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37228 | $8918.70 | 1861694259 - HARSHIT MODI | 350593390 - DEACONESS HOSPITAL INC | IN | Hospitalist Physician (208M00000X) |
United | 37228 | $4750.00 | 1083220123 - QUEENS SURGICAL CENTER LLC | 471041427 - (NY) QUEENS SURGICAL CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37228 | $1512.00 | 1952336521 - CASC AQUISITION INC, CAROLINA AMBULATORY SURGERY CENTER | 810576467 - (SC) CASC AQUISITION INC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37228 | $8024.00 | 1063099190 - ASCENSION SAINT THOMAS LEBANON SURGERY CENTER LLC, LEBANON SURGERY CENTER | 862679471 | TN | 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 37228 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 37228 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 37228 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 |
|---|---|---|
| 37228-CPT | High | Revascularization, Endovascular, Open Or Percutaneous, Tibial, Peroneal Artery, Unilateral, Initial Vessel; With Transluminal Angioplasty |
| 37229-CPT | High | Revascularization, Endovascular, Open Or Percutaneous, Tibial, Peroneal Artery, Unilateral, Initial Vessel; With Atherectomy, Includes Angioplasty Within The Same Vessel, When Performed |
| 37230-CPT | High | Revascularization, Endovascular, Open Or Percutaneous, Tibial, Peroneal Artery, Unilateral, Initial Vessel; With Transluminal Stent Placement(S), Includes Angioplasty Within The Same Vessel, When Performed |
| 37231-CPT | High | Revascularization, Endovascular, Open Or Percutaneous, Tibial, Peroneal Artery, Unilateral, Initial Vessel; With Transluminal Stent Placement(S) And Atherectomy, Includes Angioplasty Within The Same Vessel, When Performed |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 37228. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 37228 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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