CPT 33405 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 51 - Multiple procedures |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 33405 |
| Medicaid Fee Schedule | View Medicaid rates for 33405 |
National average reimbursement for CPT 33405 by major payers:
$2,942.63
$3,145.02
$3,407.86
$3,637.35
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 33405 | $990.00 | 1154034429 - CROSSINGS SURGERY CENTER, LLC | 881346867 - (RI) CROSSINGS SURGERY CENTER LLC | RI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33405 | $580.00 | 1992022297 - MID VALLEY SURGERY CENTER LLC | 263177194 - (CA) MID VALLEY SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33405 | $258.00 | 1871052712 - KURESMART PAIN MANAGEMENT SURGERY CENTER-COLUMBIA LLC, CLEARWAY SURGERY CENTER OF COLUMBIA | 834028893 - (MD) KURESMART PAIN MANAGEMENT SURGERY CENTERCOLUMBIA LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33405 | $303.00 | 1043497019 - PIKESVILLE MD ENDOSCOPY ASC LLC, ENDOCENTRE OF BALTIMORE | 261467040 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33405 | $578.00 | 1942884457 - CVI AMBULATORY SURGERY CENTER LLC | 844815499 - (FL) CVI AMBULATORY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33405 | $555.00 | 1255634044 - RED HILLS SURGICAL CENTER, LLC | 264736988 - (FL) RED HILLS SURGICAL CENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33405 | $1796.98 | 1235653908 - AMANDA MILEY | 350593390 - DEACONESS HOSPITAL INC | IN | Clinical Nurse Specialist (364S00000X) |
United | 33405 | $695.00 | 1093736795 - HATTIESBURG CLINIC PA, AMBULATORY SURGERY CENTER | 640507572 - HATTIESBURG CLINIC, P.A. | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33405 | $993.00 | 1205152618 - MINNESOTA EYE LASER & SURGERY CENTERS, LLC, MINNESOTA EYE LASER & SURGERY CENTERS | 460505033 - (MN) MINNESOTA EYE LASER SURGERY CENTERS LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33405 | $5554.00 | 1508837899 - MEMORIAL HERMANN SURGERY CENTER NORTHWEST, LLP, MEMORIAL HERMANN SURGERY CENTER GREATER HEIGHTS | 200689650 - (TX) MEMORIAL HERMANN SURGERY CENTER NORTHWEST LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33405 | $1064.00 | 1912434697 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33405 | $3911.10 | 1477582930 - SHIRISHKUMAR PATEL | 350593390 - DEACONESS HOSPITAL INC | KY | Internal Medicine Physician (207R00000X) |
United | 33405 | $3911.10 | 1134482193 - LEE MURPHY | 350593390 - DEACONESS HOSPITAL INC | IN | Pediatric Critical Care Medicine Physician (2080P0203X) |
United | 33405 | $399.00 | 1306320338 - ALABAMA EYE SURGERY CENTER LLC | 814662532 - (AL) ALABAMA EYE SURGERY CENTER LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33405 | $1000.00 | 1447612114 - LPC SURGERY CENTER LLC | 473748606 - (IN) LPC SURGERY CENTER LLC | 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 33405 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 33405 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 33405 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 |
|---|---|---|
| 33390-CPT | High | Repair Of Heart Valve, Surgery To Open A Heart Valve (Aortic) That Has Become Stuck Closed By Scar Tissue Or Inflammation. Heart-Lung Bypass Is Used. The Tissue Is Separated By Cutting Or Progressive Dilation (Manually Widening The Opening). |
| 33391-CPT | High | Repair Of Heart Valve, Surgery To Open A Heart Valve (Aortic) That Has Become Stuck Closed By Scar Tissue Or Inflammation. Heart-Lung Bypass Is Used. The Tissue Is Separated By Cutting Or Progressive Dilation (Manually Widening The Opening). |
| 33405-CPT | High | Surgery To Replace Heart Valve, Surgery To Replace A Valve Between The Lower Left Heart Chamber And The Aorta. The Replacement May Be Fully Artificial Or Made Of Biologically Similar Tissue. Heart-Lung Bypass Allows The Heart To Rest During Surgery. |
| 33406-CPT | High | Surgery To Replace Heart Valve, Surgery To Replace A Valve Between The Lower Left Heart Chamber And The Aorta. The Replacement May Be Fully Artificial Or Made Of Biologically Similar Tissue. Heart-Lung Bypass Allows The Heart To Rest During Surgery. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 33405. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 33405 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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