What is the standard insurance baseline for CPT 33641?

The standard insurance baseline reimbursement rate is $791.74. This represents the customary allowable amount established across standard fee schedules.

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CPT 33641Medical Service

Repair of Congenital Defect Between Upper Heart Chambers on Heart-lung Machine

Q: What do doctors typically charge for Repair of Congenital Defect Between Upper Heart Chambers on Heart-lung Machine?

The nationwide median physician charge for Repair of Congenital Defect Between Upper Heart Chambers on Heart-lung Machine (CPT 33641) is $4779.46. Doctor billed charges vary based on geographic region, setting, and overhead.

Repair of congenital defect between upper heart chambers on heart-lung machine. Clinical pricing breakdown and utilization metrics across 15 practicing doctors nationwide.

$4779.46

Peer Median Charge

Gross billed rate

$791.74

Standard Baseline

Customary allowable

6.0x

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 $4779.46. However, insured patients almost never pay this full amount directly. Insurers negotiate rates down toward the $791.74 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 33641 if paid upfront?"
"Are there separate facility, anesthesia, or pathology fees associated with this procedure?"