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See a sample rate comparisonCPT 33542 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.
Myocardial Resection
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Cardiovascular System |
| Common Place of Service | 21 - Inpatient Hospital 99 - Other POS 11 - Office 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 | $2,455.63 national non-facility rate (2026) · View Medicare rates for 33542 |
| Medicaid Fee Schedule | $1,914.25 median of the 8 states in the free preview · View Medicaid rates for 33542 |
National average reimbursement for CPT 33542 by major payers:
$3,373.73
$3,521.51
$3,767.64
$4,108.83
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CPT 33542
5 of 25 sample ratesHigher to lower in this preview
Roc Surgery LLC, Riley Outpatient Surgery Center
Roc Surgery LLC
$7,400.00Published rateEncinitas Endoscopy Center, LLC, The Endoscopy Center
$1,274.00Published rateFranklin Surgical Center, LLC
Franklin Surgical Center
$850.00Published rateSouthpoint Surgery Center, LLC
$445.00Published rateEndoscopy Center Of Santa Maria Inc, The Endoscopy Center Of Santa Maria, Inc.
Endoscopy Center Of Santa Maria, Inc.
$124.00Published rate
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See a sample payer proposalCPT 33542 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 33542 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 33542 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 |
|---|---|---|
| 33542-CPT | High | Myocardial Resection |
| 33545-CPT | High | Heart Partition Repair, Surgery After A Heart Attack To Repair The Partition Separating The Two Sides Of The Heart (Septum). All Muscle Tissue That Has Died From Loss Of Blood Is Removed And The Septum May Be Rebuilt With Synthetic Material. |
| 33548-CPT | High | Heart Chamber Restoration, Surgery To Repair The Left Lower Heart Chamber (Ventricle) After A Heart Attack. Damage Or Scarring Has Reshaped And Enlarged The Heart. The Procedure Inserts A Patch To Restore Normal Shape And Improve Blood Flow And Oxygen To The Heart. |
| 33606-CPT | High | Heart Blood Vessel Surgery, Surgery To Combine Blood Flow Of The Two Major Heart Arteries. Flow From The Right Side Of The Heart Is Shifted Over To The Flow From The Left Side Of The Heart (Aorta). This Enables A Single Chamber To Pump Blood To The Body. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 33542. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 33542 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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