CPT 33426 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 33426 |
National average reimbursement for CPT 33426 by major payers:
$3,016.59
$3,263.25
$3,546.82
$3,875.36
| 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 33426 | ||||||
United | 33426 | $750.00 | 1063750867 - MENLO PARK SURGERY CENTER, LLC. | 263669436 - (NJ) MENLO PARK SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33426 | $700.00 | 1154046019 - GEORGIA INTERVENTIONAL PAIN | 880572909 - (GA) GEORGIA INTERVENTIONAL PAIN | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33426 | $1064.00 | 1093772840 - THE SURGERY CENTER AT JENSEN BEACH, LLC | 651198731 - (FL) THE SURGERY CENTER AT JENSEN B | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33426 | $611.00 | 1154422541 - BRUNSWICK PAIN TREATMENT CENTER, LLC | 562441571 - (GA) BRUNSWICK PAIN TREATMENT CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33426 | $1049.00 | 1245711803 - SURGCENTER CLEARWATER, LLC, SURGCENTER DUNEDIN | 823682684 - (FL) SURGCENTER CLEARWATER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33426 | $758.00 | 1336635747 - ROCKVILLE SURGICAL SUITES, LLC | 825263227 - (MD) ROCKVILLE SURGICAL SUITES LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33426 | $523.00 | 1316233612 - CPMSC CARROLLTON | 274203105 - (GA) CPMSC CARROLLTON | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33426 | $524.00 | 1336112200 - MERCER COUNTY SURGERY CENTER LLC, MERCER COUNTY SURGERY CENTER | 223774069 - (NJ) MERCER COUNTY SURGERY CENTER, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33426 | $200.00 | 1497087399 - DELMONT SURGERY CENTER, LLC | 270683745 - (PA) DELMONT SURGERY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33426 | $500.00 | 1033282173 - TEMECULA VALLEY DAY SURGERY & PAIN THERAPY CENTER, INC. | 330469645 - (CA) TEMECULA VALLEY DAY SURGERY PAIN THERAPY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33426 | $544.00 | 1467097725 - CENTER FOR SURGERY PLLC | 843638195 - (ID) CENTER FOR SURGERY PLLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33426 | $693.00 | 1841325214 - AMBULATORY CENTER FOR AESTHETIC AND RECONSTRUCTIVE SURGERY | 208422547 - (MD) AMBULATORY CENTER FOR AESTHETIC AND RECONSTRUCTIVE SURGERY | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33426 | $1370.00 | 1962505354 - PROVIDENCE HEALTH SERVICES OF WACO, PROVIDENCE HEALTH CENTER | 741109636 - (TX) ASCENSION PROVIDENCE | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33426 | $782.00 | 1568420388 - GREAT LAKES SURGICAL CENTER LLC | 562350398 - (MI) GREAT LAKES SURGICAL CENTER LL | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33426 | $5500.00 | 1609148592 - I-4 WEST SURGICAL SERVICES, LLC | 320364002 - (FL) I4 WEST SURGICAL SERVICES LLC | FL | 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 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 | Once Per Dos Transcatheter Mitral Valve Repair, Percutaneous Approach, Including Transseptal Puncture When Performed; Initial Prosthesis |
| 33419-CPT | Moderate | 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 | Valvotomy Mitral Closed |
| 33426-CPT | High | Valvuloplsty,Mitral Valve,W/Bypass;W/Pro |
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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