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See a sample rate comparisonCPT 33463 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 The Heart Valve (Tricuspid) That Allows Blood To Flow Between The Upper And Lower Chambers On The Right 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 82 - Assistant surgeon - no qualified resident |
| Complexity Level | High |
| Medicare Fee Schedule | $2,865.46 national non-facility rate (2026) · View Medicare rates for 33463 |
| Medicaid Fee Schedule | $2,234.565 median of the 8 states in the free preview · View Medicaid rates for 33463 |
National average reimbursement for CPT 33463 by major payers:
$3,826.36
$4,069.49
$4,549.37
$4,771.65
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CPT 33463
5 of 25 sample ratesHigher to lower in this preview
Physicians West Surgicenter, LLC
$2,705.00Published rateCreekwood Surgery Center, Lp
Creekwood Surgery Center Lp
$1,049.00Published rateMeadow Lake Surgery Center Inc
$825.00Published rateDigestive Health Specialists, PA
Digestive Health Specialists, P.A.
$445.00Published rateEuclid Endoscopy Center, Lp
Euclid Endoscopy Center Lp
$254.00Published rate
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See a sample payer proposalCPT 33463 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 33463 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 33463 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 |
|---|---|---|
| 33460-CPT | High | Removal Of Heart Valve, Surgery With Heart-Lung Bypass To Remove The Tricuspid Valve. This Heart Valve Separates The Upper And Lower Right Chambers. |
| 33463-CPT | High | Heart Valve Surgery, Surgery To Repair The Heart Valve (Tricuspid) That Allows Blood To Flow Between The Upper And Lower Chambers On The Right Side Of The Heart. An Artificial Ring Is Inserted To Narrow The Mouth Of The Valve. |
| 33464-CPT | High | Heart Valve Surgery, Surgery To Repair The Heart Valve (Tricuspid) That Allows Blood To Flow Between The Upper And Lower Chambers On The Right Side Of The Heart. An Artificial Ring Is Inserted To Narrow The Mouth Of The Valve. |
| 33465-CPT | High | Heart Valve Replacement, Surgery With Heart-Lung Bypass To Replace The Heart Tricuspid Valve (Between Lower And Upper Right Chambers). The Replacement May Be Fully Artificial Or Made From Biologically Similar Tissue. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 33463. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 33463 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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