CPT 33864 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 • 82 - Assistant surgeon - no qualified resident |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 33864 |
National average reimbursement for CPT 33864 by major payers:
$4,029.15
$4,428.18
$4,840.24
$5,241.88
| 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 33864 | ||||||
United | 33864 | $2732.00 | 1912993833 - SURGICENTER OF KANSAS CITY, LLC | 431828920 - (MO) SURGICENTER OF KANSAS CITY, LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33864 | $2302.00 | 1710940218 - DENVER MID-TOWN SURGERY CENTER LTD | 752548180 - DENVER MIDTOWN SURGERY CENTER LTD | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33864 | $322.00 | 1205917101 - CATARACT & LASER CENTER, INC. | 42907424 - (MA) THE CATARACT AND LASER CENTER, I | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33864 | $1064.00 | 1174778047 - RSC ILLINOIS LLC, REGIONAL SURGICENTER | 261363389 | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33864 | $569.00 | 1144650060 - SAN ANTONIO CHILDRENS SURGICAL | 464050149 - (TX) SAN ANTONIO CHILDRENS SURGICAL | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33864 | $436.00 | 1104899855 - SOUTHFIELD ENDOSCOPY ASC LLC, GASTROINTESTINAL ENDOSCOPY CENTER | 943421929 | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33864 | $1146.00 | 1336131143 - PHOENIX ORTHOPAEDIC AMBULATORY CENTER, LLC, GATEWAY SURGERY CENTER | 860970374 - (AZ) PHOENIX ORTHOPAEDIC AMBULATORY CENTER, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33864 | $524.00 | 1447366224 - WEST MICHIGAN SURGERY CENTER, LLC | 371509502 - (MI) MICHIGAN PRIMARY CARE PARTNERS PC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33864 | $2652.00 | 1528049855 - CENTER FOR AESTHETIC AND RECONSTRUCTIVE EYELID AND ORBITAL SURGERY, CAREOS | 844484446 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33864 | $773.00 | 1255345229 - BEACON ORTHOPAEDICS SURGERY CENTER, LLC, SUMMIT SURGERY CENTER | 311800570 - (OH) BEACON ORTHOPAEDICS SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33864 | $872.00 | 1225568884 - WAKE FOREST AMBULATORY VENTURES, LLC | 820777206 - (NC) WAKE FOREST AMBULATORY VENTURES LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33864 | $1028.00 | 1194724690 - ENDOSCOPY CENTER OF DAYTON NORTH LLC | 311703317 - (OH) ENDOSCOPY CENTER OF DAYTON NORTH LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33864 | $347.00 | 1902020522 - ROME SURGICAL CENTER, P.C. | 208847972 - (GA) ROME SURGICAL CENTER PC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33864 | $2101.00 | 1922301712 - THE SURGERY CENTER AT WILLIAMSON LLC | 270929515 - (TX) THE SURGERY CENTER AT WILLIAMSON LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33864 | $4893.00 | 1427491547 - MEMORIAL HERMANN TEXAS INTERNATIONAL ENDOSCOPY CENTER, LLC, TEXAS INTERNATIONAL ENDOSCOPY CENTER | 462464605 | TX | 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 33864 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 33864 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 33864 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 33864. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 33864 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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