CPT 33516 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Cardiovascular System |
| Common Place of Service | • 21 - Inpatient Hospital • 11 - Office • 50 - Federally Qualified Health Center |
| Common Modifiers | • None • 82 - Assistant surgeon - no qualified resident • AS - PA/NP/CNS assistant at surgery |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 33516 |
National average reimbursement for CPT 33516 by major payers:
$3,690.04
$3,709.12
$3,909.41
$4,389.84
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 33516 | ||||||
United | 33516 | $993.00 | 1578003208 - MINNESOTA EYE LASER & SURGERY CENTERS, LLC | 460505033 - (MN) MINNESOTA EYE LASER SURGERY CENTERS LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33516 | $983.00 | 1235146325 - WEBSTER AMBULATORY SURGERY CENTER LP, WEBSTER SURGERY CENTER | 205953387 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33516 | $5554.00 | 1336391085 - MEMORIAL HERMANN SURGERY CENTER KINGSLAND LLC, MEMORIAL HERMANN SURGERY CENTER KINGSLAND | 263464776 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33516 | $983.00 | 1871594275 - DESTIN SURGERY CENTER LLC | 593723179 - (FL) DESTIN SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33516 | $365.00 | 1326189499 - KUNESH EYE SURGERY CENTER | 311298414 - (OH) KUNESH EYE SURGERY CENTER | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33516 | $1167.00 | 1255373601 - CHESTERFIELD AMBULATORY SURGERY CENTER LP, CHESTERFIELD SURGERY CENTER | 203834076 - (MO) CHESTERFIELD AMBULATORY SURGERY CENTER LP | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33516 | $384.00 | 1861001372 - BAY SURGERY CENTERS LLC | 204934078 - (MD) BAY SURGERY CENTERS LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33516 | $1136.00 | 1962435990 - NORTHERN MONMOUTH REGIONAL SURGERY CENTER LLC, CENTER FOR BONE AND JOINT SURGERY | 201026094 - (NJ) NORTHERN MONMOUTH REGIONAL SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33516 | $333.00 | 1891724936 - ARKLAMISS SURGERY CENTER,LLC | 870741444 - (LA) ARKLAMISS SURGERY CENTERLLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33516 | $100.00 | 1871596114 - NORTHERN ARIZONA SURGICENTER, LLC | 860747413 - (AZ) NORTHERN ARIZONA SURGICENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33516 | $1049.00 | 1003861998 - PHYSICIANS SURGERY CENTER OF CHATTANOOGA, LLC, PHYSICIANS SURGERY CENTER OF CHATTANOOGA | 621817952 - (TN) PHYSICIANS SURGERY CENTER OF CHATTANOOGA LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33516 | $430.00 | 1215400320 - SURGERY CENTER AT GATEWAY LLC | 823763830 - (MI) SURGERY CENTER AT GATEWAY LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33516 | $537.00 | 1407993132 - DIGESTIVE DISEASE ENDOSCOPY CENTER | 352597463 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33516 | $2897.00 | 1477590545 - SOUTHERN HILLS MEDICAL CENTER, LLC, SOUTHERN HILLS HOSPITAL & MEDICAL CENTER | 743048428 - (NV) SOUTHERN HILLS MEDICAL CENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33516 | $1050.00 | 1487612024 - QUAD CITY AMBULATORY SURGERY CENTER LLC | 364471903 - (IL) QUAD CITY AMBULATORY SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 33516 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 33516 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 33516 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 |
|---|---|---|
| 33514-CPT | High | Coronary Artery Bypass, Autog.Graft;5 Co |
| 33516-CPT | High | Coronary Artery Bypass, Autogenous Graft, (Eg, Saphenous Vein Or Internal Mammary Artery); Six Or More Coronary Graf |
| 33519-CPT | Moderate | Coronary Artery Bypass Using Venous Graft(S) And Arterial Graft(S); Three Venous Grafts (List Separately In Addition To Code For Primary Procedure) |
| 33523-CPT | High | Coronary Artery Bypass Using Venous Graft(S) And Arterial Graft(S); Six Or More Venous Grafts (List Separately In Addition To Code For Primary Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 33516. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 33516 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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