CPT 33859 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 • 22 - On Campus Outpatient Hospital • 11 - Office |
| Common Modifiers | • None • AS - PA/NP/CNS assistant at surgery • 80 - Assistant surgeon |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 33859 |
National average reimbursement for CPT 33859 by major payers:
$3,050.90
$3,430.43
$3,522.63
$3,971.93
| 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 33859 | ||||||
United | 33859 | $402.00 | 1003889346 - ENDOSCOPY GROUP LLC | 593519881 - (FL) ENDOSCOPY GROUP, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33859 | $706.00 | 1659679074 - EYE SURGERY CENTER OF MIDDLE TENNESSEE, LLC | 275124581 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33859 | $750.00 | 1568814010 - SURGERY CENTER OF CALIFORNIA -LLC | 812978830 - (CA) SURGERY CENTER OF CALIFORNIA LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33859 | $350.00 | 1528166113 - SOUTHERN BONE & JOINT AMBULATORY SURGICAL CENTER, LLC, SOUTHERN BONE & JOINT, LLC | 582558264 - (GA) SOUTHERN BONE JOINT AMBULATORY SURGICAL CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33859 | $4825.00 | 1447320213 - FREEHOLD ENDOSCOPY ASSOCIATES, LLC, ENDOSCOPY CENTER OF MONMOUTH COUNTY | 841634126 - (NJ) FREEHOLD ENDOSCOPY ASSOCIATES | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33859 | $66.00 | 1598879512 - NORTHLAND EYE SURGERY CENTER, LLC | 203685944 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33859 | $250.00 | 1821372467 - THE EYE SURGICENTER OF NEW JERSEY, LLC | 453067378 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33859 | $445.00 | 1477500767 - SOUTHPOINT SURGERY CENTER, LLC | 203579196 - (FL) SOUTHPOINT SURGERY CENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33859 | $315.00 | 1720081664 - HEATON LASER AND SURGERY CENTER L L C | 752752100 - (TX) HEATON LASER AND SURGERY CENTER L L C | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33859 | $900.00 | 1346210259 - SURGICARE LLC | 351975122 - (IN) SURGICARE LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33859 | $2164.00 | 1366137440 - SURGERY CENTER OF GEORGETOWN, LLC, GEORGETOWN SURGERY CENTER | 880604963 - (TX) SURGERY CENTER OF GEORGETOWN LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33859 | $712.00 | 1669660817 - SPH IRVINE, L.L.C. | 752507129 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33859 | $600.00 | 1316406523 - JOHNS HOPKINS SURGERY CENTERS SERIES, GREEN SPRING STATION SURGERY CENTER | 208707724 - (MD) JOHNS HOPKINS SURGERY CENTER SERIES | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33859 | $540.00 | 1750469789 - ORTHOPEDIC SURGERY CENTER LLC, ORTHOPEDIC SURGERY CENTER | 364568309 - (LA) ORTHOPEDIC SURGERY CENTER, LLC. | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33859 | $572.00 | 1508863242 - BUFFALO SURGERY CENTER LLC | 161574540 - (NY) BUFFALO SURGERY CENTER LLC | NY | 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 33859 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 33859 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 33859 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 |
|---|---|---|
| 33858-CPT | High | Ascending Aorta Graft With Cardiopulmonary Bypass Includes Valve Suspension When Performed; For Aortic Dissection |
| 33859-CPT | High | Ascending Aorta Graft With Cardiopulmonary Bypass Includes Valve Suspension When Performed; For Aortic Disease Other Than Dissection (Eg Aneurysm) |
| 33863-CPT | High | Ascending Aorta Graft With Cardiopulmonary Bypasswith Valve Suspension; With Coronary Reconstruction And Valve-Sparing Aortic Root Remodeling (Eg David Procedure Yacoub Procedure) |
| 33864-CPT | High | Ascending Aorta Graft, With Cardiopulmonary Bypass With Valve Suspension, With Coronary Reconstruction And Valve-Sparing Aortic Root Remodeling (Eg, David Procedure, Yacoub Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 33859. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 33859 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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