CPT 37238 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 • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | High |
National average reimbursement for CPT 37238 by major payers:
$4,001.79
$4,954.62
$5,529.05
$5,698.54
| 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 37238 | ||||||
United | 37238 | $15900.00 | 1902228455 - PROVIDENCE HEALTH & SERVICES WASHINGTON, PROVIDENCE SURGERY AND PROCEDURE CENTER | 881232814 - (WA) PROVIDENCE SURGERY AND PROCEDURE CENTER LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37238 | $4590.00 | 1982853271 - WESTERN WASHINGTON ENDOSCOPY CENTERS LLC, SUNRISE ENDOSCOPY CENTER | 200289310 - (WA) WESTERN WASHINGTON ENDOSCOPY CENTERS LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37238 | $1607.00 | 1780206292 - GREECE ASC, LLC, CORNERSTONE SURGERY CENTER | 824108616 - (NY) GREECE ASC LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37238 | $3578.00 | 1386749943 - QUAIL SURGICAL AND PAIN MANAGEMENT CENTER, LLC | 880391609 - (NV) QUAIL SURGICAL & PAIN MANAGEMENT CENTER, LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37238 | $11320.00 | 1124084843 - ST CLOUD OUTPATIENT SURGERY LTD | 752201400 | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37238 | $8492.00 | 1245605633 - HARBOR HEIGHTS SURGERY CENTER, LLC | 473886948 - (MD) HARBOR HEIGHTS SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37238 | $1562.00 | 1629173075 - THE DIGESTIVE ENDOSCOPY CENTER OF MICHIGAN, PLLC, CROWNE POINT ENDOSCOPY & SURGERY CENTER | 352227535 - (MI) THE DIGESTIVE ENDOSCOPY CENTER OF MICHIGAN PLLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37238 | $12582.00 | 1568950996 - HOLLYWOOD REGIONAL SURGERY CENTER LLC | 825140248 - (FL) HOLLYWOOD REGIONAL SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37238 | $4946.00 | 1184689010 - PARK CITIES SURGERY CENTER, LLC, PARK CITIES SURGERY CENTER | 562357079 - (TX) PARK CITIES SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37238 | $3960.00 | 1225523970 - BURNSVILLE SURGERY CENTER, P.A. | 830965169 - (MN) BURNSVILLE SURGERY CENTER PA | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37238 | $18309.00 | 1104996768 - GREATER DAYTON SURGERY CENTER LLC | 202913367 - (OH) GREATER DAYTON SURGERY CENTER | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37238 | $8750.00 | 1013104389 - TRACY SURGERY CENTER, LLC, TRACY SURGERY CENTER, LLC | 203762687 - (CA) TRACY SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37238 | $9548.00 | 1659316917 - SUGAR LAND SURGERY CENTER LTD | 621742196 - (TX) SUGAR LAND SURGERY CENTER LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37238 | $2676.00 | 1932390234 - RENO ORTHOPAEDIC SURGERY CENTER LLC | 208256389 - (NV) RENO ORTHOPAEDIC SURGERY CENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 37238 | $3058.00 | 1376789248 - PIONEER AMBULATORY SURGERY CENTER, LLC | 262749514 - (NC) PIONEER AMBULATORY SURGERY CENTER LLC | NC | 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 37238 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 37238 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 37238 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 |
|---|---|---|
| 37236-CPT | High | Transcatheter Placement Of An Intravascular Stent (S) (Except Lower Extremity Artery(S) For Occlusive Disease Cervial Carotid Extracranial Vertebral Or Intrathoracic Carotid Intracranial Or Coronary) Open Or Percutaneous Including Radiological Supervision And Interpretation And Including All Angioplasty Within The Same Vessel When Performed; Initial Artery (Desc Revised 01/01/15) |
| 37237-CPT | High | Transcatheter Placement Of An Intravascular Stent (S) (Except Lower Extremity Artery(S) For Occlusive Disease Cervial Carotid Extracranial Vertebral Or Intrathoracic Carotid Intracranial Or Coronary) Open Or Percutaneous Including Radiological Supervision And Interpretation And Including All Angioplasty Within The Same Vessel When Performed; Each Additional Artery (List Separately In Addition To Code For Primary Procedure) (Desc Revised 01/01/15) |
| 37238-CPT | High | Transcatheter Placement Of An Intravascular Stent(S), Open Or Percutaneous, Including Radiological Supervision And Interpretation And Including Angioplasty Within The Same Vessel, When Performed; Initial Vein |
| 37239-CPT | High | Transcatheter Placement Of An Intravascular Stent(S) Open Or Percutaneous Including Radiological Supervision And Interpretation And Including Angioplasty Within The Same Vessel Whenperformed; Each Additional Vein (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 37238. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 37238 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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