CPT 33916 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 |
| Common Modifiers | • None • 82 - Assistant surgeon - no qualified resident • GC - Service performed by resident under supervision |
| Complexity Level | High |
National average reimbursement for CPT 33916 by major payers:
$4,958.53
$4,884.42
$5,583.28
$6,121.43
| 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 33916 | ||||||
United | 33916 | $900.00 | 1225123227 - COMPREHENSIVE PAIN MANAGEMENT CENTER, INC. | 770533953 - (CA) COMPREHENSIVE PAIN MANAGEMENT CENTER, INC. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33916 | $403.00 | 1023399318 - CANDESCENT EYE SURGICENTER LLC | 452898656 | RI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33916 | $351.00 | 1710290606 - GEORGIA NEUROSURGICAL INSTITUTE OUTPATIENT SURGERY CENTER, GEORGIA NEUROSURGICAL INSTITUTE OUTPATIENT SURGERY CENTER | 271921975 - (GA) GEORGIA NEUROSURGICAL INSTITUTE OUTPATIENT SURGERY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33916 | $1049.00 | 1104298009 - RED CEDAR SURGERY CENTER, LLC, RED CEDAR SURGERY CENTER, PLLC | 472947364 - (MI) RED CEDAR SURGERY CENTER, PLLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33916 | $410.00 | 1346288032 - ENDOSCOPY CENTER AT RIDGE PLAZA LP, ENDOSCOPY CENTER AT MEDPOINT | 383656538 - (TX) ENDOSCOPY CENTER AT MED POINT | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33916 | $11123.00 | 1225064876 - ROCK HILL SURGERY CENTER, LLC, CAROLINA SURGICAL CENTER | 752562111 - (SC) ROCK HILL SURGERY CENTER LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33916 | $501.00 | 1063935286 - CHESNUT INSTITUTE OF COSMETIC & RECONSTRUCTIVE SURGERY | 821592877 - (WA) CLINIC 5C | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33916 | $4300.00 | 1144275900 - MT LAUREL ENDOSCOPY CENTER L P | 562350370 - (NJ) MT LAUREL ENDOSCOPY CENTER L P | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33916 | $324.00 | 1801073648 - ELITE ENDOSCOPY LLC | 202722461 - (NV) ELITE ENDOSCOPY LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33916 | $16236.00 | 1396774543 - WISCONSIN SURGERY CENTER LLC | 383661215 - (WI) WISCONSIN SURGERY CENTER, LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33916 | $523.00 | 1700369071 - ALLIANCE SURGERY CENTER AT MARIETTA, LLC | 831521891 - (GA) ALLIANCE SURGERY CENTER AT MARIETTA LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33916 | $1169.00 | 1558612762 - QUEENS BOULEVARD ASC LLC | 274614930 | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33916 | $1028.00 | 1396211264 - PALM BEACH SURGICAL SUITES LLC | 830558319 - (FL) PALM BEACH SURGICAL SUITES LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33916 | $430.00 | 1306963020 - BATTLE CREEK ENDOSCOPY & SURGERY LLC | 201914507 - (MI) BATTLE CREEK ENDOSCOPY & SURGERY CENTER PLLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 33916 | $570.00 | 1801323191 - NS SURGICAL CENTER LLC | 814954399 - (KS) NS SURGICAL CENTER LLC | KS | 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 33916 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 33916 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 33916 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 |
|---|---|---|
| 33915-CPT | High | Embolectomy Pulmon Artery Wo Bypass |
| 33916-CPT | High | Pulmonary Endarterectomy W/Wo Embolectmy |
| 33917-CPT | High | Repair Pulmonary Artery Stenosis By Reconstruction With Patch Or Graft |
| 33920-CPT | High | Repair Of Pulmonary Atresia With Ventricular Septal Defect, By Construction Or Replacement Of Conduit From Right Or Left Ventricle To Pulmonary Artery |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 33916. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 33916 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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