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See a sample rate comparisonCPT 33916 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.
Repair Major Artery To Lung, Surgery To Clear Out A Blockage From The Pulmonary (Lung) Artery. The Pulmonary Artery Carries Blood To The Lungs From The Heart.
| 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 | 82 - Assistant surgeon - no qualified resident GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | $3,853.46 national non-facility rate (2026) · View Medicare rates for 33916 |
| Medicaid Fee Schedule | $2,980.68 median of the 8 states in the free preview · View Medicaid rates for 33916 |
National average reimbursement for CPT 33916 by major payers:
$4,958.53
$4,884.42
$5,583.28
$5,985.73
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CPT 33916
5 of 25 sample ratesHigher to lower in this preview
Alaska Surgery Center, Limited Partnership
Alaska Surgery Center Limited Partnership
$4,115.00Published rateCorpus Christi Surgicare Ltd, Christus Spohn Texas Orthopedic Center Of Excellence
Corpus Christi Surgicare Ltd
$1,274.00Published rateSurgcenter Of Bel Air
Surgcenter Of Bel Air, LLC
$644.00Published rateWest Clinic Astc, West Clinic, PC
The West Clinic, PLLC
$420.00Published rateAims Outpatient Surgery
$100.00Published rate
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See a sample payer proposalCPT 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 | Removal Of Blood Clot, Surgery To Remove A Blood Clot From The Pulmonary (Lung) Artery. The Pulmonary Artery Carries Blood From The Heart To The Lungs. |
| 33916-CPT | High | Repair Major Artery To Lung, Surgery To Clear Out A Blockage From The Pulmonary (Lung) Artery. The Pulmonary Artery Carries Blood To The Lungs From The Heart. |
| 33917-CPT | High | Rpair Of Pulmona Arter Stenosis By Reconstr W/ Patch Or Gr, Repair Of Pulmonary Artery Stenosis By Reconstruction With Patch Or Gr |
| 33920-CPT | High | Surgery To Repair Heart Defect, Surgery To Repair One Or More Defects Of The Heart Valves Blood Vessels Or Chambers. The Procedure Can Involve Moving Blood Vessels Reconstructing Valves And Repairing The Wall Between The Chambers (Septum). |
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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