CPT 33259 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 • AS - PA/NP/CNS assistant at surgery • 80 - Assistant surgeon |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 33259 |
National average reimbursement for CPT 33259 by major payers:
$1,118.63
$1,167.13
$1,247.96
$1,405.20
| 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 33259 | ||||||
United | 33259 | $1064.00 | 1538390539 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33259 | $250.00 | 1043625221 - INTERVENTIONAL SURGERY INSTITUTE OF LITTLE ROCK, LLC, INTERVENTIONAL SURGERY INSTITUTE | 471050942 - (AR) INTERVENTIONAL SURGERY INSTITUTE OF LITTLE ROCK LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33259 | $362.00 | 1154555472 - GEORGIA RETINA SURGERY CENTER, LLC | 262303683 - (GA) GEORGIA RETINA SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33259 | $381.00 | 1710924881 - GEORGIA DERMASURGERY CENTERS, INC. | 582495671 - (GA) GEORGIA DERMASURGERY CENTERS INC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33259 | $477.00 | 1023005139 - ROANOKE VALLEY CENTER FOR SIGHT LLC | 541982898 - (VA) ROANOKE VALLEY CENTER FOR SIGHT LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33259 | $1126.00 | 1700838471 - SANTA CRUZ SURGERY CENTER | 770194916 - (CA) SANTA CRUZ SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33259 | $800.00 | 1790145480 - TWIN CITIES SURGERY CENTER | 463311193 - (MN) TWIN CITIES SURGERY CENTER | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33259 | $307.00 | 1457077174 - BATTLE STREET SURGERY CENTER, LLC | 920682808 - (AR) BATTLE STREET SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33259 | $284.00 | 1629038989 - SAN ANTONIO EYE CENTER, PA, SAN ANTONIO EYE SURGICENTER | 741916103 - (TX) SAN ANTONIO EYE CENTER, PA | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33259 | $983.00 | 1154956928 - ADVANCED SURGICAL CARE OF CLEARWATER LLC | 833698204 - (FL) ADVANCED SURGICAL CARE OF CLEARWATER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33259 | $1049.00 | 1699777540 - PHYSICIANS SURGERY CENTER OF TEMPE, LLC, PHYSICIANS SURGERY CENTER OF TEMPE | 731538769 - (AZ) PHYSICIANS SURGERY CENTER OF TEMPE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33259 | $289.00 | 1598847139 - ORTHOPAEDIC ASSOCIATES SURGERY CENTER, LLC | 582623564 - (GA) ORTHOPAEDIC ASSOCIATES SURGERY CTR, LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33259 | $703.00 | 1477502979 - INLAND EAR NOSE AND THROAT A MEDICAL GROUP INC, FOOTHILL AMBULATORY SURGERY CENTER | 953300822 - (CA) M.M. KANOK, M.D., A MEDICAL CORPORA | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33259 | $475.00 | 1427545540 - ORBIS SURGERY CENTER LLC | 825184428 - (TX) ORBIS SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33259 | $107.00 | 1750658092 - ADVANCED CENTER FOR SURGERY, LLC | 273049891 - (PA) ADVANCED CENTER FOR SURGERY, LLC | PA | 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 33259 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 33259 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 33259 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 |
|---|---|---|
| 33251-CPT | High | Operative Ablation Of Supraventricular Arrhythmogenic Focus Or Pathway (Eg, Wolff-Parkinson-White, Atrioventricular Node Re-Entry), Tract(S) And/Or Focus (Foci); With Cardiopulmonary Bypass |
| 33255-CPT | High | Operative Tissue Ablation And Reconstruction Of Atria Extensive Without Cardiopulmonary Bypass |
| 33256-CPT | High | With Cardiopulmonary Bypass |
| 33259-CPT | High | Operative Tissue Ablation And Reconstruction Of Atria Performed At The Time Of Other Cardiac Procedure(S) Extensive (Eg Maze Procedure) Withcardiopulmonary Bypass (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 33259. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 33259 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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