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See a sample rate comparisonCPT 33426 Fee Schedule
Last Verified: October 2026
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.
Heart Valve Surgery, Surgery To Repair A Heart Valve (Mitral) That Moves Blood Between The Upper And Lower Chambers On The Left Side Of The Heart. An Artificial Ring Is Inserted To Narrow The Mouth Of The Valve.
| 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 | AS - PA/NP/CNS assistant at surgery 51 - Multiple procedures |
| Complexity Level | High |
| Medicare Fee Schedule | $2,231.85 national non-facility rate (2026) · View Medicare rates for 33426 |
| Medicaid Fee Schedule | $1,740.90 median of the 8 states in the free preview · View Medicaid rates for 33426 |
National average reimbursement for CPT 33426 by major payers:
$3,016.59
$3,263.25
$3,546.82
$3,792.88
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CPT 33426
5 of 25 sample ratesHigher to lower in this preview
I-4 West Surgical Services, LLC
I4 West Surgical Services LLC
$5,500.00Published rateThe Surgery Center At Jensen Beach, LLC
The Surgery Center At Jensen B
$1,064.00Published rateGreat Lakes Surgical Center LLC
Great Lakes Surgical Center Ll
$782.00Published rateBrunswick Pain Treatment Center, LLC
Brunswick Pain Treatment Center LLC
$611.00Published rateDelmont Surgery Center, LLC
Delmont Surgery Center LLC
$200.00Published rate
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See a sample payer proposalCPT 33426 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 33426 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 33426 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 |
|---|---|---|
| 33418-CPT | High | Transcatheter Mitral Valve Rep, Transcatheter Mitral Valve Repair Percutaneous Approach Including Transseptal Puncture When Performed Initial Prosthesis |
| 33419-CPT | Moderate | Repair Tcat Mitral Valve, Transcatheter Mitral Valve Repair Percutaneous Approach Including Transseptal Puncture When Performed Additional Prosthesis Es During Same Session List Separately In Addition To Code For Primary Procedure |
| 33420-CPT | High | Heart Valve Surgery, Surgery To Open The Heart Valve (Mitral) That Moves Blood Between The Left Upper And Lower Heart Chambers. Scar Tissue Or Inflammation Has Closed The Valve. The Stuck Tissue Is Cut Apart Or Separated By Progressive Dilation (Manually Widening The Opening). |
| 33426-CPT | High | Heart Valve Surgery, Surgery To Repair A Heart Valve (Mitral) That Moves Blood Between The Upper And Lower Chambers On The Left Side Of The Heart. An Artificial Ring Is Inserted To Narrow The Mouth Of The Valve. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 33426. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 33426 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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