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See a sample rate comparisonCPT 33468 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 Repair, Surgery To Reposition Or Repair A Heart Valve (Tricuspid). This Valve Separates The Upper And Lower Right Heart Chambers.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Cardiovascular System |
| Common Place of Service | 21 - Inpatient Hospital 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | 80 - Assistant surgeon 82 - Assistant surgeon - no qualified resident |
| Complexity Level | High |
| Medicare Fee Schedule | $2,271.60 national non-facility rate (2026) · View Medicare rates for 33468 |
| Medicaid Fee Schedule | $1,756.23 median of the 8 states in the free preview · View Medicaid rates for 33468 |
National average reimbursement for CPT 33468 by major payers:
$2,987.89
$3,190.73
$3,387.69
$3,770.44
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CPT 33468
5 of 25 sample ratesHigher to lower in this preview
Aurora Gi Asc LLC, Wisconsin Digestive Health Center
Aurora Gi Asc LLC
$16,236.00Published rateBerkshire Eye, LLC
$1,064.00Published rateLegacy Center For Spinal Surgery, LLC
Legacy Center For Spinal Surgery LLC
$656.00Published rateAndersen Eye Surgery Center, LLC
Andersen Eye Surgery Center LLC
$430.00Published rateArizona Surgical Arts, Inc.
Arizona Surgical Arts Inc
$100.00Published rate
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See a sample payer proposalCPT 33468 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 33468 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 33468 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. |
| 33468-CPT | High | Heart Valve Repair, Surgery To Reposition Or Repair A Heart Valve (Tricuspid). This Valve Separates The Upper And Lower Right Heart Chambers. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 33468. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 33468 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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