CPT 33863 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 • 23 - Emergency Room |
| Common Modifiers | • None • AS - PA/NP/CNS assistant at surgery • 82 - Assistant surgeon - no qualified resident |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 33863 |
National average reimbursement for CPT 33863 by major payers:
$4,074.77
$4,299.01
$4,680.69
$5,079.11
| 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 33863 | ||||||
United | 33863 | $602.00 | 1386739498 - GEORGIA LITHOTRIPSY AND LASER CENTER | 581879891 - (GA) GEORGIA LITHOTRIPSY AND LASER CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33863 | $450.00 | 1831349406 - GASTROENTEROLOGY EAST, P.A. | 202964888 - (NC) GASTROENTEROLOGY EAST, P.A. | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33863 | $406.00 | 1679570774 - NOVAMED SURGERY CENTER OF MADISON, LIMITED PARTNERSHIP | 201915800 - (WI) NOVAMED SURGERY CENTER OF MADISON LIMITED PARTNERSHIP | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33863 | $955.00 | 1184749673 - WAYNE SURGICAL CENTER LLC | 223535325 - (NJ) WAYNE SURGICAL CENTER, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33863 | $6068.00 | 1366047433 - MANSFIELD ENDOSCOPY CENTER, LLC | 861354607 - (TX) MANSFIELD ENDOSCOPY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33863 | $439.00 | 1760196984 - JACKSON HEART AND VASCULAR CENTER LLC | 870947298 - (MS) JACKSON HEART AND VASCULAR CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33863 | $493.00 | 1104877976 - VICTOR R. MICHALAK, DBA COSMETIC SURGERY & DERMATOLOGY OF ISSAQUAH, INC. | 911521306 | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33863 | $625.00 | 1649269663 - PHYSICIANS ALLIANCE LC, PHYSICIANS ALLIANCE SURGERY CENTER | 431832038 - (MO) PHYSICIANS ALLIANCE LC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33863 | $1028.00 | 1326114869 - EL PASO CENTER FOR GASTROINTESTINAL ENDOSCOPY, LLC | 201482218 - (TX) EL PASO CENTER FOR GASTROINTESTINAL ENDOSCOPY LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33863 | $2416.00 | 1205364981 - MERCED AMBULATORY SURGERY CENTER, LLC, UNIVERSITY SURGERY CENTER | 611845381 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33863 | $1274.00 | 1699284018 - ONYX & PEARL SURGICAL SUITES LLC | 821183739 - (OH) ONYX & PEARL SURGICAL SUITES, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33863 | $951.00 | 1629461934 - NORTHERN EC LLC | 464211412 | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33863 | $1104.00 | 1447457403 - BERGEN GASTROENTEROLOGY PC | 222713168 - (NJ) BERGEN GASTROENTEROLOGY, P.C. | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33863 | $158.00 | 1356311419 - RIVERSIDE AMBULATORY SURGERY CENTER LLC | 522233625 - (MD) RIVERSIDE AMBULATORY SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33863 | $1049.00 | 1881969269 - SURGERY CENTRE OF SW FLORIDA LLC, CAPE HEALTH SURGERY CENTER | 454068750 | FL | 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 33863 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 33863 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 33863 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 33863. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 33863 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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