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See a sample rate comparisonCPT 33478 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 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.
| 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 | 51 - Multiple procedures 82 - Assistant surgeon - no qualified resident |
| Complexity Level | High |
| Medicare Fee Schedule | $1,493.35 national non-facility rate (2026) · View Medicare rates for 33478 |
| Medicaid Fee Schedule | $1,166.595 median of the 8 states in the free preview · View Medicaid rates for 33478 |
National average reimbursement for CPT 33478 by major payers:
$2,086.68
$2,192.97
$2,282.09
$2,554.83
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CPT 33478
5 of 25 sample ratesHigher to lower in this preview
Lexington Health Inc, Lmc Northeast Asc
Lexington Health Inc
$3,557.00Published rateChildrens Surgery Center LLC, Adventhealth Surgery Center Maitland
Childrens Surgery Center LLC
$1,416.00Published rateAtlantic Coast Surgical Suites, LLC
Atlantic Coast Surgical Suites LLC
$1,064.00Published rateBayview Medical Center, Inc, Lmc Ambulatory Surgery Center
$475.00Published rateArizona Surgical Specialists Center, LLC
Arizona Surgical Specialists Center LLC
$105.00Published rate
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See a sample payer proposalCPT 33478 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 33478 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 33478 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 |
|---|---|---|
| 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. |
| 33478-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. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 33478. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 33478 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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