Revenue Code 0360 in Medical Billing for Operating Room

Hospitals speak a financial language of their own, and revenue codes are a big part of it. These four-digit codes turn clinical services into billable charges and tell the payer which department or cost center the care came from. Imaging, anesthesia, recovery and surgery each have their own code. The operating room codes carry extra weight because they capture some of the most resource-intensive services a hospital provides.

Revenue code 0360, often written as rev code 360, reports operating room facility charges for surgical procedures. Used correctly, it ties the surgical CPT code to the hospital’s operating room charge so the facility side of the surgery is paid without a denial. This guide explains what 0360 covers, how it differs from related codes, how it appears on a claim and how a medical billing company keeps these claims clean.

What Is Revenue Code 0360?

A Revenue Code in medical billing is a three- or four-digit code used to identify specific services or departments for which a hospital is billing. Revenue code for surgery, commonly referred to as rev code 0360, is used for billing hospital facility fees related to surgical procedures. This is an important revenue code that links operating room facility fees with proper hospital reimbursement, ensuring accurate claim processing and payment.

Definition of Revenue Code 0360

A revenue code is a four-digit code maintained by the National Uniform Billing Committee (NUBC) that identifies the department or type of service behind a hospital charge. Revenue code 0360 is Operating Room Services, General Classification. Hospitals report it on institutional claims, the UB-04 or its electronic version the 837I, when a surgical procedure is performed in the hospital’s operating room. Medicare contractors list it in the 036X Operating Room Services family, as shown in Noridian’s revenue code table.

The charge on a 0360 line represents the hospital’s cost of providing the operating room. It does not include the surgeon’s fee.

Classification as an Operating Room (OR) Revenue Code

0360 is the general code within the operating room family. Assigning it correctly tells the payer where the procedure took place, supports compliance and protects surgical reimbursement, because the payer reads the revenue code alongside the CPT code to understand what the hospital is charging for.

Who Uses It

Acute care hospitals and hospital outpatient departments report 0360 for surgery performed in the operating room, on both inpatient and outpatient claims. Critical access hospitals use it the same way on their institutional claims.

Revenue Code 0360 in Ambulatory Surgery Centers

Medicare ambulatory surgery centers do not use revenue codes. They bill the facility fee on the CMS-1500 or 837P, as set out in the Medicare Claims Processing Manual, Chapter 14. Some Medicaid programs and commercial payers require ASCs to bill on a UB-04 instead, usually with bill type 0831 and revenue code 0490 rather than 0360. Pennsylvania Medicaid, for example, publishes a UB-04 billing guide for ASCs. An ASC should always follow the billing manual of the payer it is billing.

Pro Tip: Report revenue code 0360 with the CPT or HCPCS code for the procedure on outpatient claims, and review your OR charge lines on a regular schedule. A medical billing audit catches mismatched codes and missed charges before they turn into denials.

Is 0360 a CPT Code?

No. 0360 is a revenue code, not a CPT code. Revenue codes come from the NUBC and tell the payer which hospital department produced a charge. CPT codes are five-digit codes from the American Medical Association that describe the procedure itself. On a hospital claim, the two sit side by side: 0360 says the charge came from the operating room and the CPT code says what was done there.

If you were searching for a CPT code that looks like 0360, the closest match is 0360T, a Category III code for behavior assessment that was deleted in 2019 and replaced by the 97151 to 97158 series, as shown in this Category III to Category I crosswalk.

What Revenue Code 0360 Covers

Revenue code 0360 carries the hospital’s costs of running the operating room while a procedure is performed.

Use of OR Space During Surgical Procedures

A 0360 charge also reflects the time and space the procedure occupied in the operating room. It shows the payer how much of the hospital’s surgical capacity the case consumed.

Non-Physician Overhead Related to Surgery

0360 includes overhead that has nothing to do with the physician’s work, such as nursing support, surgical instruments and the preparation and maintenance of the room. These non-physician costs make up a large part of every OR charge.

Examples of Covered Services

Typical cases include general surgery, orthopedic surgery and cardiovascular surgery performed in the main operating room. Strong revenue cycle management makes sure the facility costs of these cases are captured, posted correctly and paid in full.

Examples of Covered Services
Services commonly processed with this revenue code include general surgical procedures such as orthopedic and cardiovascular surgeries requiring the main operating room. Healthcare revenue cycle management services ensure accurate capture of facility costs, proper charge posting, and optimized reimbursement for these procedures.

When to Use Revenue Code 0360

Revenue code 0360 belongs on the claim whenever the hospital bills for a procedure performed in its operating room. Getting the setting, the claim fields and the CPT pairing right is what makes it pay.

Inpatient vs Outpatient Hospital Settings

0360 applies in both inpatient and outpatient settings whenever the patient uses the operating room. The revenue code does not change with the setting. The type of bill does: 0111 for an inpatient claim, 0131 for a hospital outpatient claim and 0851 for a critical access hospital outpatient claim.

Surgical Procedures Requiring a Formal Operating Room

Use 0360 when the procedure takes place in the main operating room. Procedures performed outside the OR belong under other revenue codes, such as 0761 for a treatment room or 0750 for an endoscopy suite. Procedures the hospital classifies as minor surgery go to 0361.

Proper Placement on the UB-04 Claim Form

On the UB-04, 0360 goes in form locator 42, the revenue code field. The description goes in form locator 43, the CPT or HCPCS code and any modifiers in 44, the date of service in 45, the units in 46 and the total charge in 47. The 837I carries the same information on the service line.

Relationship to Primary Surgical CPT Codes

On outpatient claims, revenue code 0360 is reported with the CPT code that describes the surgery. That pairing is what lets the payer price the facility charge. It covers the hospital side only. The surgeon bills the same CPT code separately on a CMS-1500, and the two claims are paid under different systems.

Pro Tip: Match revenue code 0360 with the primary surgical CPT code on every outpatient UB-04 line, and confirm the type of bill before submission. The bill type, not the revenue code, is what changes between inpatient and outpatient claims.

What Revenue Code 0360 Does NOT Cover

0360 covers the hospital’s operating room charges, but several costs of a surgical case go on their own lines or their own claims.

Professional (Physician and Surgeon) Fees

The surgeon’s professional fee is never billed under 0360. Physicians bill their services with CPT codes on the CMS-1500. The one exception is a critical access hospital that bills under the optional method, which reports professional fees on its UB-04 with the 096X to 098X professional fee revenue codes.

Recovery Room Services (Rev Code 0710)

Post-operative care in the recovery room is not part of 0360. It is billed under revenue code 0710, Recovery Room, which covers monitoring and nursing care after surgery.

Anesthesia Services (Rev Code 0370)

Anesthesia is not included in 0360. The hospital reports its own anesthesia charges under revenue code 0370, Anesthesia. The anesthesiologist or CRNA bills the professional anesthesia service separately.

Implants, Lenses and Sterile Supplies

Supplies and devices go on their own revenue lines: 0272 for sterile supplies, 0278 for other implants, 0276 for intraocular lenses and 0274 for prosthetic and orthotic devices. Under Medicare’s outpatient system most of these items are packaged into the procedure payment, so they appear on the claim without being paid line by line.

Revenue Code 0360 vs Other 036X Codes

Revenue code 0360 belongs to the 036X family, Operating Room Services. Only five codes in this family are in active use, and each one describes the type of surgery rather than the type of room.

Codes 0363 to 0366 and 0368 are not in use by CMS, so a Medicare claim that reports them will be returned. Source: Noridian revenue code table.ect reimbursement. Always check documentation to avoid claims denials and correct coding errors.

When to Use 0360 vs a More Specific 036X Code

Use 0360 for most surgery in the operating room. Use 0362 or 0367 for transplant surgery, 0361 when the chargemaster classifies the procedure as minor surgery and 0369 for OR services that fit no other code.

Surgical Revenue Codes Compared

Several revenue codes describe surgical or procedural care, and choosing between them is where many claims go wrong. This table shows the codes most often confused with 0360.

Source: Noridian revenue code table.

Common CPT Codes Paired with Revenue Code 0360

Revenue code 0360 tells the payer where the surgery happened, and the CPT code tells it what was done. The two have to agree for the claim to process.

Typical Surgical CPT Code Ranges (10000 to 69990)

Most CPT codes reported with 0360 come from the Surgery section of CPT, codes 10000 to 69990. That range covers general, orthopedic, cardiovascular, gynecologic and eye surgery, so the hospital’s OR charge lines up with the service actually performed.

Examples of Frequently Paired CPT Codes

Common pairings include total knee arthroplasty (27447), laparoscopic cholecystectomy (47562), cataract extraction with lens implant (66984) and open aortic valve replacement (33405). The table below gives more examples with their correct descriptions.

Importance of CPT and Revenue Code Alignment

When the CPT code describes a procedure that is normally performed in an operating room, the 0360 charge makes sense to the payer. When it does not, the line is likely to deny, so coders should check the pairing before the claim leaves.

Accurate Billing Guidelines for Revenue Code 0360

Clean 0360 claims come from four habits: complete claim fields, correct units, the right facility modifiers and no duplicate charges.

Claim Form Requirements (UB-04 / 837I)

Report the operating room charge with revenue code 0360 in the revenue code field of the UB-04 or 837I. Complete the line with the date of service, the CPT or HCPCS code for the procedure, any modifiers, the units and the total charge.

Sample Outpatient Surgery Claim With Revenue Code 0360

A patient has a laparoscopic cholecystectomy in the hospital’s main OR and goes home the same day. The hospital bills a UB-04 with bill type 0131. A simplified set of claim lines could look like this:

The surgeon bills 47562 separately on a CMS-1500, and the anesthesiologist or CRNA bills their own professional claim. Payer rules on which lines need a HCPCS code vary, so check the payer manual before building the chargemaster.

Units, Charges and Service Dates

Units for 0360 depend on how the hospital prices its operating room in the chargemaster and on payer rules. Many hospitals price OR time in increments, while others price by procedure level. The charge must match the documented OR use, and the service date must be the actual date of surgery.

Modifier Considerations

Facility claims use a different set of modifiers than physician claims. The ones that matter most on 0360 lines are 73 and 74 for outpatient procedures discontinued before or after anesthesia, 52 for reduced services, 50 for bilateral procedures, RT and LT for laterality and 59 or the X modifiers (XE, XS, XP, XU) for distinct procedures. Using them correctly keeps the CPT code and the OR charge aligned and prevents underpayment.

Avoiding Unbundling and Duplicate Billing

Use 0360 only for operating room facility charges. Do not fold professional fees, anesthesia or recovery room care into it, and do not bill the same service under 0360 and another revenue code, because duplicate charges invite audits.

Documentation Checklist for Revenue Code 0360

Precise documentation is what supports a 0360 charge if the payer reviews it. These records should be complete before the claim is sent.

Operative Report

The operative report is the primary support for a 0360 charge. It should name the procedure performed, the surgical team and any special equipment used in the room.

Date and Duration of OR Use

Record the date and the in-room and out-of-room times for every case. These times connect the OR charge to the resources the hospital actually used.

Procedure Performed

Document the procedure clearly enough to support the CPT or HCPCS code on the claim, so the 0360 line matches the service rendered.

Medical Necessity Documentation

The record should show why the patient needed surgery in an operating room, including the diagnosis and the indications for the procedure.

Supporting Hospital Records

Nursing notes, anesthesia records and equipment logs back up the 0360 charge. Complete supporting records make a claim much harder to deny on review.

Reimbursement for Operating Room Facility Charges

How Revenue Code 0360 Is Paid

Under Medicare’s outpatient system, payment attaches to the CPT or HCPCS code on the 0360 line, which groups into an Ambulatory Payment Classification (APC). Most related charges, such as supplies, anesthesia and recovery, are packaged into that payment, so they appear on the claim but are not paid line by line.

Inpatient stays are paid by MS-DRG. Whether the DRG is surgical depends on the ICD-10-PCS procedure codes and whether they are designated operating room procedures, not on the presence of revenue code 0360. The 0360 charges still matter for cost reporting and outlier calculations.

Commercial payers vary. Some pay a case rate by procedure, some pay a percentage of billed charges and some pay for OR time separately. Each contract decides.

What Payers Pay for Revenue Code 0360

There is no single rate for 0360. Published price transparency data compiled by PayerPrice shows national averages of about $2,556 for BCBS, $20,041 for UnitedHealthcare, $5,344 for Aetna and $1,459 for Cigna, as of October 2026. The spread is wide because each contract defines the 0360 rate differently, by case, by unit of time or as a percentage of charges, so these figures are a market signal rather than an expected payment.

Factors Affecting Payment Amounts

Payment for revenue code 0360 depends on the complexity of the procedure, the time spent in the OR, the hospital’s contract with each payer and geographic adjustments. Accurate documentation, correct CPT pairing and the right revenue code are what let the hospital collect the full contracted amount.

Common Denials Related to Operating Room Facility Charges

Most 0360 denials trace back to a coding or documentation gap that could have been caught before submission. Denial management finds the cause, corrects the claim and resubmits it so the OR charge is paid.

Missing or Invalid Code

A missing CPT code on an outpatient 0360 line, a mistyped code or a revenue code CMS does not use, such as 0363, will stop the claim. Every 0360 line needs a valid surgical CPT or HCPCS code.

Mismatch Between CPT and Revenue Code

A denial follows when the CPT code describes a procedure that is not normally performed in an operating room. Make sure the CPT code matches a surgical service that justifies the 0360 charge.

Non-Covered Procedure

If the payer’s policy does not cover the procedure in an operating room setting, the facility charge will deny along with it. Check coverage and prior authorization requirements before scheduling.

Lack of Medical Necessity

A 0360 charge needs documentation that justifies operating room use. Operative reports, clinical notes and the preoperative evaluation should all support the need for surgery.

How to Correct and Appeal 0360 Denials

Start with the denial reason. If the CPT and revenue code do not align, correct the claim and resubmit it. If the payer questioned medical necessity, send the operative report and supporting records with a short explanation. Submitting a clean claim the first time is still the fastest way to get paid.

Payer-Specific and State Rules for Operating Room Billing

Revenue code 0360 has one national definition, but the rules for paying it vary by payer and by state.

Medicare-Specific Guidance

Medicare recognizes only the 036X codes in active use and expects a surgical CPT or HCPCS code on each outpatient 0360 line. Follow your Medicare Administrative Contractor’s billing guidance for revenue code and HCPCS requirements.

State Differences in Medicaid

State Medicaid programs can set their own rules for 0360, including covered procedures, documentation and allowed facility charges. Some also require ASCs to bill on a UB-04, so hospitals and surgery centers should check each state’s Medicaid provider manual.

Commercial Payer Policies

Commercial payers differ widely. Some pay the OR facility fee separately, while others bundle it with the procedure payment. Confirm each payer’s policy before billing 0360.

Reviewing Payer Contracts and Fee Schedules

Review payer contracts, fee schedules and policy updates on a regular schedule. This keeps 0360 billing aligned with each payer and protects reimbursement for operating room charges.

How iSolve RCM Supports Revenue Code 0360

Accurate billing under revenue code 0360 is what lets a hospital collect in full for its operating room. iSolve RCM validates revenue codes, checks that each 0360 line pairs with the right CPT code and applies payer-specific rules before the claim goes out. With iSolve’s outsourced medical billing services, hospitals reduce OR claim denials, stay compliant and streamline the documentation and reporting behind every operating room charge.

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