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See a sample rate comparisonCPT 33430 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 Replace The Heart Valve (Mitral) That Regulates Blood Flow Between The Upper And Lower Chambers Of The Left Side Of The Heart.
| 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 80 - Assistant surgeon |
| Complexity Level | High |
| Medicare Fee Schedule | $2,622.97 national non-facility rate (2026) · View Medicare rates for 33430 |
| Medicaid Fee Schedule | $2,046.185 median of the 8 states in the free preview · View Medicaid rates for 33430 |
National average reimbursement for CPT 33430 by major payers:
$3,635.18
$3,786.49
$4,165.76
$4,413.94
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CPT 33430
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center Texas Medical Center, LLP, Memorial Hermann Surgery Center Texas Medical Center
Memorial Hermann Surgery Center Texas Medical Center LLP
$4,893.00Published rateMetroeast Endoscopic Surgery Center
$1,000.00Published rateUsa Baldwin County Asc, LLC, Baldwin County Surgery Center
Usa Baldwin County Asc LLC
$625.00Published rateEye Surgery Center Of Chester County, LLC, Vision One Laser & Surgery Center
Eye Surgery Center Of Chester County, LLC
$487.00Published ratePalestine Laser & Surgery Center PLLC
Palestine Laser Surgery Center PLLC
$112.00Published rate
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See a sample payer proposalCPT 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 | 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 |
| 33425-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. |
| 33430-CPT | High | Heart Valve Surgery, Surgery To Replace The Heart Valve (Mitral) That Regulates Blood Flow Between The Upper And Lower Chambers Of The Left Side Of The Heart. |
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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