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See a sample rate comparisonCPT 33496 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 To Replaced Heart Valve, Surgery With Heart-Lung Bypass To Repair A Malfunctioning Replacement Heart Valve. The Procedure May Include Removal Of Tissue That Has Grown Over 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 |
| Common Modifiers | 78 - Return to OR - related procedure 22 - Increased Procedural Services |
| Complexity Level | High |
| Medicare Fee Schedule | $1,586.54 national non-facility rate (2026) · View Medicare rates for 33496 |
| Medicaid Fee Schedule | $1,345.37 median of the 8 states in the free preview · View Medicaid rates for 33496 |
National average reimbursement for CPT 33496 by major payers:
$2,199.80
$2,314.43
$2,395.96
$2,689.06
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CPT 33496
5 of 25 sample ratesHigher to lower in this preview
Charles Cole Memorial D/B/A UPMC Cole, Short Procedure Unit
UPMC
$9,383.00Published rateHhc Hartford Surgery Center, LLC
$1,215.00Published rateSouth Sound Surgery, PLLC, Auburn Surgical Center
South Sound Surgery PLLC
$650.00Published rateCleburne Endoscopy Center, LLC
Cleburne Endoscopy Center LLC
$410.00Published rateClearer Vision, LLC, Perimeter Surgery Center
Clearer Vision, LLC
$100.00Published rate
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See a sample payer proposalCPT 33496 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 33496 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 33496 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. |
| 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. |
| 33496-CPT | High | Repair To Replaced Heart Valve, Surgery With Heart-Lung Bypass To Repair A Malfunctioning Replacement Heart Valve. The Procedure May Include Removal Of Tissue That Has Grown Over The Valve. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 33496. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 33496 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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