What is the standard insurance baseline for CPT 33259?

The standard insurance baseline reimbursement rate is $798.35. This represents the customary allowable amount established across standard fee schedules.

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CPT 33259Medical Service

Extensive Destruction and Reconstruction of Right Upper Heart Chamber on Heart-lung Machine

Q: What do doctors typically charge for Extensive Destruction and Reconstruction of Right Upper Heart Chamber on Heart-lung Machine?

The nationwide median physician charge for Extensive Destruction and Reconstruction of Right Upper Heart Chamber on Heart-lung Machine (CPT 33259) is $2488.11. Doctor billed charges vary based on geographic region, setting, and overhead.

Extensive destruction and reconstruction of right upper heart chamber on heart-lung machine. Clinical pricing breakdown and utilization metrics across 52 practicing doctors nationwide.

$2488.11

Peer Median Charge

Gross billed rate

$798.35

Standard Baseline

Customary allowable

3.1x

National Markup

Charge vs baseline

Active Physicians

Billing this code

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Understanding This Medical Fee

Gross Charge vs Negotiated Payment: The median physician charge for this service is $2488.11. However, insured patients almost never pay this full amount directly. Insurers negotiate rates down toward the $798.35 baseline.

Self-Pay & Uninsured Guidance: If you are paying without insurance or out-of-network, request a prompt-pay cash discount. Most medical practices are willing to settle self-pay bills near the customary baseline rate rather than the full gross charge.

Key Questions for Your Doctor's Billing Office:

"Does Dr. [Name] participate in my specific insurance plan network?"
"What is the total self-pay or cash rate for code 33259 if paid upfront?"
"Are there separate facility, anesthesia, or pathology fees associated with this procedure?"