CPT 33406 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 |
| Common Modifiers | • None • 22 - Increased Procedural Services • 82 - Assistant surgeon - no qualified resident |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 33406 |
National average reimbursement for CPT 33406 by major payers:
$3,892.47
$3,918.19
$4,132.33
$4,642.77
| 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 33406 | ||||||
United | 33406 | $4530.00 | 1497244149 - HOSPITAL FOR SPECIAL SURGERY WEST SIDE AMBULATORY SURGERY CENTER, LLC, HSS WEST SIDE ASC, LLC | 814351390 | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33406 | $516.00 | 1073546875 - STRAND GASTROINTESTINAL ENDOSCOPY CENTER | 571082826 - (SC) STRAND GASTROINTESTINAL ENDOSCOPY CENTER | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33406 | $1049.00 | 1831489335 - HAGERSTOWN SURGERY CENTER,LLC | 274935096 - (MD) HAGERSTOWN SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33406 | $994.26 | 1679694004 - GI SPECIALISTS LLC, MORELAND ENDOSCOPY CENTER | 205269133 - (WI) GI SPECIALISTS LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33406 | $983.00 | 1891298089 - MICHIGAN OUTPATIENT SURGICAL SOLUTIONS, LLC | 821706937 - (MI) MICHIGAN OUTPATIENT SURGICAL SOLUTIONS LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33406 | $500.00 | 1861496564 - DIGESTIVE HEALTHCARE OF GEORGIA ENDOSCOPY CENTER | 582406657 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33406 | $724.00 | 1497727119 - DIGESTIVE ENDOSCOPY CENTER LLC, DIGESTIVE ENDOSCOPY CENTER | 311508446 - (OH) DIGESTIVE ENDOSCOPY CENTER, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33406 | $2737.00 | 1295213734 - LOS GATOS SURGICAL CENTER, A CALIFORNIA LIMITED PARTNERSHIP, ENDOSCOPY CENTER OF SILICON VALLEY | 942909203 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33406 | $1028.00 | 1891298089 - MICHIGAN OUTPATIENT SURGICAL SOLUTIONS, LLC | 821706937 - (MI) MICHIGAN OUTPATIENT SURGICAL SOLUTIONS LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33406 | $1049.00 | 1215116611 - UPPER BAY SURGERY CENTER, LLC | 205547410 - (MD) UPPER BAY SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33406 | $449.00 | 1629404918 - CENTRAL ARKANSAS SURGERY CENTER, LLC | 462585307 - (AR) CENTRAL ARKANSAS SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33406 | $66.00 | 1598879512 - NORTHLAND EYE SURGERY CENTER, LLC | 203685944 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33406 | $1274.00 | 1558401299 - SAN GABRIEL VALLEY SURGICAL CENTER LP | 752965449 - (CA) SAN GABRIEL VALLEY SURGICAL CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33406 | $514.00 | 1699748855 - MIDDLETOWN ENDOSCOPY ASC LLC, THE GI ENDOSCOPY CENTER | 621835826 - (OH) MIDDLETOWN ENDOSCOPY ASC LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33406 | $619.00 | 1912909144 - THE UROLOGY CENTER, PC, UROLOGY CENTER ASC | 470593275 - (NE) THE UROLOGY CENTER, P.C. | NE | 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 33406 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 33406 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 33406 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 | Valvuloplasty Aortic Valve Open With Cardio- Pulmonary Bypass; Simple (Ie Valvotomy Debride-Ment Debulking And/Or Simple Commissural Re- Suspension) |
| 33391-CPT | High | Valvuloplasty, Aortic Valve, Open, With Cardiopulmonary Bypass; Complex (Eg, Leaflet Extension, Leaflet Resection, Leaflet Reconstruction, Or Annuloplasty) |
| 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) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 33406. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 33406 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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