CPT 33404 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 • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • AS - PA/NP/CNS assistant at surgery • XU - Unusual Non-Overlapping Service |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 33404 |
National average reimbursement for CPT 33404 by major payers:
$2,282.85
$2,438.30
$2,511.39
$2,886.52
| 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 33404 | ||||||
United | 33404 | $438.00 | 1366496143 - VIRGINIA SURGERY CENTER, LLC, CVP SURGERY CENTER | 541922041 - (VA) VIRGINIA SURGERY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33404 | $1169.00 | 1588938682 - WEST SIDE GI, LLC | 271185812 - (NY) WESTSIDE GI CENTER, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33404 | $285.00 | 1538153994 - SOUTH FLORIDA CENTER FOR ENDOSCOPY & DIGESTIVE DISEASE LLC, KENDALL ENDOSCOPY & SURGERY CENTER | 651112489 - (FL) SOUTH FLORIDA CENTER FOR ENDOSCOPY & DIGESTIVE DISEASE, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33404 | $273.00 | 1417118407 - MSC AMBULATORY SURGICAL CENTER, LLC | 202155076 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33404 | $2575.00 | 1659316917 - SUGAR LAND SURGERY CENTER LTD | 621742196 - (TX) SUGAR LAND SURGERY CENTER LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33404 | $1029.00 | 1952648966 - WENATCHEE VALLEY HOSPITAL, CONFLUENCE HEALTH OMAK ASC | 455563741 - WENATCHEE VALLEY HOSPITAL | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33404 | $350.00 | 1225490196 - OLNEY ENDOSCOPY CENTER | 473544166 - (MD) OLNEY ENDOSCOPY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33404 | $537.00 | 1558451583 - LIPPY SURGERY CENTER LLC | 205293709 - (OH) LIPPY SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33404 | $1231.00 | 1326004110 - GROSSMONT SURGERY CENTER LP | 330749339 - (CA) GROSSMONT SURGERY CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33404 | $1146.00 | 1881339133 - BSC SHEA PARK LLC | 881850069 - (AZ) BSC SHEA PARK LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33404 | $200.00 | 1922193515 - MAHONING VALLEY AMBULATORY SURGERY CENTER INC | 233056394 - (PA) MAHONING VALLEY AMBULATORY SURGERY CENTER INC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33404 | $2377.00 | 1215990247 - SOUTHERN HILLS SURGERY CENTER LP, SOUTHERN HILLS SURGERY CENTER | 200533890 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33404 | $350.00 | 1871941468 - AMBULATORY SURGERY CENTER FOR PELVIC NEURO SCIENCE LLC | 812463581 - (MD) AMBULATORY SURGERY CENTER FOR PELVIC NEURO SCIENCE LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33404 | $7400.00 | 1689053050 - BELTWAY SURGERY CENTERS, LLC, MULTISPECIALTY SURGERY CENTER | 352072586 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33404 | $300.00 | 1518922541 - VISION SURGICAL CENTER AT SPRINGHILL PSC | 352100428 - (IN) VISION SURGICAL CENTER AT SPRINGHILL PSC | 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 33404 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 33404 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 33404 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 |
|---|---|---|
| 33404-CPT | High | Construction Of Apical-Aortic Conduit |
| 33405-CPT | High | Replacement Aortic Valve Open With Cardiopulmonary Bypass; With Prosthetic Valve Other Than Homograft Or Stentless Valve. (Desc Revised 1/1/2017) |
| 33406-CPT | High | Replacement, Aortic Valve, Open, With Cardiopulmonary Bypass; With Allograft Valve (Freehand) |
| 33410-CPT | High | Replacement, Aortic Valve, Open, With Cardiopulmonary Bypass; With Stentless Tissue Valve |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 33404. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 33404 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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