CPT 33430 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 • 80 - Assistant surgeon |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 33430 |
National average reimbursement for CPT 33430 by major payers:
$3,635.18
$3,786.49
$4,165.76
$4,510.08
| 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 33430 | ||||||
United | 33430 | $625.00 | 1649961640 - USA BALDWIN COUNTY ASC, LLC, BALDWIN COUNTY SURGERY CENTER | 844335937 - (AL) USA BALDWIN COUNTY ASC LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33430 | $141.00 | 1225452303 - MARTHA JEFFERSON HOSPITAL, MARTHA JEFFERSON OUTPATIENT SURGERY CENTER | 540261840 - (VA) MARTHA JEFFERSON HOSPITAL | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33430 | $500.00 | 1033468442 - CORNERSTONE SURGICARE LLC | 460563529 - (FL) CORNERSTONE SURGICARE LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33430 | $650.00 | 1356814958 - CLEVELAND CHILDRENS SURGERY CENTER LLC | 301128634 - (OH) CLEVELAND CHILDRENS SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33430 | $852.00 | 1437250248 - GEORGIA SURGICAL CENTER ON PEACHTREE, LLC | 582394271 - (GA) GEORGIA SURGICAL CENTER ON PEACHTREE LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33430 | $4893.00 | 1659301794 - MEMORIAL HERMANN SURGERY CENTER TEXAS MEDICAL CENTER, LLP, MEMORIAL HERMANN SURGERY CENTER TEXAS MEDICAL CENTER | 203233666 - (TX) MEMORIAL HERMANN SURGERY CENTER TEXAS MEDICAL CENTER LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33430 | $112.00 | 1932212511 - PALESTINE LASER & SURGERY CENTER PLLC | 470900270 - (TX) PALESTINE LASER SURGERY CENTER PLLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33430 | $2302.00 | 1336790237 - AURORA ENDOSCOPY SURGICENTER, LLC | 825396997 - (CO) AURORA ENDOSCOPY SURGICENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33430 | $983.00 | 1740778554 - ORO VALLEY SURGICAL SUITES LLC | 823931790 - (AZ) ORO VALLEY SURGICAL SUITES, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33430 | $464.00 | 1023005139 - ROANOKE VALLEY CENTER FOR SIGHT LLC | 541982898 - (VA) ROANOKE VALLEY CENTER FOR SIGHT LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33430 | $550.00 | 1437505948 - WATER LEAF SURGERY CENTER, LTD | 811356283 - (TX) WATER LEAF SURGERY CENTER LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33430 | $1016.00 | 1528261195 - ORCHARD CREEK SURGERY CENTER | 770498874 - (CA) ORCHARD CREEK SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33430 | $487.00 | 1992784821 - EYE SURGERY CENTER OF CHESTER COUNTY, LLC, VISION ONE LASER & SURGERY CENTER | 232922796 - (PA) EYE SURGERY CENTER OF CHESTER COUNTY, LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33430 | $1000.00 | 1063838357 - METROEAST ENDOSCOPIC SURGERY CENTER | 461844105 - (IL) METROEAST ENDOSCOPIC SURGERY CENTER | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33430 | $1348.00 | 1124084843 - ST CLOUD OUTPATIENT SURGERY LTD | 752201400 | MN | 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 33430 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 33430 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 33430 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) |
| 33425-CPT | High | Valvuloplasty Mitral W Bypass |
| 33430-CPT | High | Replacement, Mitral Valve, W Cardiopul B |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 33430. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 33430 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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