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See a sample rate comparisonCPT 33474 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.
Repair Of Heart Valve, Surgery To Open The Heart Valve (Pulmonary) That Regulates Blood Flow From The Lungs. Scar Tissue Or Inflammation Has Closed The Valve. The Stuck Tissue Is Cut Apart Or Separated By Progressive Dilation (Manually Widening The Opening).
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Cardiovascular System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | AS - PA/NP/CNS assistant at surgery 82 - Assistant surgeon - no qualified resident |
| Complexity Level | High |
| Medicare Fee Schedule | $2,037.79 national non-facility rate (2026) · View Medicare rates for 33474 |
| Medicaid Fee Schedule | $1,586.89 median of the 8 states in the free preview · View Medicaid rates for 33474 |
National average reimbursement for CPT 33474 by major payers:
$2,745.26
$2,898.12
$3,120.37
$3,401.33
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CPT 33474
5 of 25 sample ratesHigher to lower in this preview
Eagle Highlands Surgery Center, LLC, Meridian South Surgery Center
$7,400.00Published rateNewport Plaza Surgery Center
$1,687.00Published rateWilmington Ambulatory Surgical Center, LLC, American Surgery Center
Wilmington Ambulatory Surgical Center LLC
$960.00Published rateWyomissing Surgical Services Inc.
Wyomissing Surgical Services Inc
$517.00Published rateAk Surgery Center, LLC
Ak Surgery Center LLC
$139.00Published rate
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See a sample payer proposalCPT 33474 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 33474 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 33474 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 |
|---|---|---|
| 33474-CPT | High | Repair Of Heart Valve, Surgery To Open The Heart Valve (Pulmonary) That Regulates Blood Flow From The Lungs. Scar Tissue Or Inflammation Has Closed The Valve. The Stuck Tissue Is Cut Apart Or Separated By Progressive Dilation (Manually Widening The Opening). |
| 33475-CPT | High | Heart Valve Replacement, Surgery To Replace The Heart Valve That Brings Blood From The Lung Into The Lower Right Heart Chamber. The Replacement Valve May Be Made From Biologically Similar Tissue. |
| 33476-CPT | High | Heart Muscle Surgery, Surgery To Modify Or Reduce Muscle Tissue At The Outlet Of The Right Heart Chamber (Ventricle) In Order To Improve Blood Flow. A Gusset Or Reinforcement May Be Used. |
| 33477-CPT | High | Replace Heart Valve, Replacement Of The Pulmonary Valve Of The Heart. The Replacement Valve Is Delivered Through A Stent (Mesh Tube) Inserted In The Blood Vessels. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 33474. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 33474 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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