How much does Medicare pay for CPT 33430?

Medicare allowed an average of $2237.18 per service and paid $1786.22 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $9808.12, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 33430?

Replacement of mitral valve on heart-lung machine. It was billed 2,320 times to 2,311 Medicare beneficiaries by 137 providers in 2024.

Which specialty bills 33430 most?

Thoracic Surgery, with 1,088 services from 68 clinicians. Next are Cardiac Surgery, Physician Assistant, General Surgery.

CPT 33430

Replacement of mitral valve on heart-lung machine

$2237.18Medicare-allowed amount per service, averaged across 2,320 services

Providers submitted

$9808.12

Asking price, not received

Medicare allowed

$2237.18

The fee schedule figure

Medicare paid

$1786.22

Balance is patient coinsurance

Providers submitted an average of $9808.12 for this code and Medicare allowed $2237.18 — 4.4× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $1786.22 (80%); the rest is the patient’s coinsurance and deductible.

Services: 2,320
Beneficiaries: 2,311
Providers billing it: 137
Total allowed: $5,190,258

What Medicare pays for CPT 33430

Across 2,320 services billed by 137 providers to 2,311 beneficiaries, Medicare allowed an average of $2237.18 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 33430

Specialty	Services	Beneficiaries	Avg allowed	Providers
Thoracic Surgery	1,088	1,085	$2456.58	68
Cardiac Surgery	878	872	$2496.09	47
Physician Assistant	214	214	$348.64	14
General Surgery	79	79	$1926.12	5
Internal Medicine	31	31	$2057.53	1
Nurse Practitioner	15	15	$356.11	1
Cardiology	15	15	$2001.85	1

33430 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Florida	302	$2291.59	$1698.90	15
California	232	$1861.80	$1380.45	15
Texas	202	$2076.56	$1660.01	10
Arizona	174	$1689.63	$1337.36	11
Pennsylvania	149	$2729.46	$2049.87	7
Ohio	120	$2265.54	$1820.54	5
Illinois	110	$2556.55	$1741.75	8
Indiana	95	$1837.64	$1631.93	5
New York	92	$2572.19	$1663.24	5
Alabama	86	$1815.24	$1531.72	5
North Carolina	72	$2074.82	$1704.43	4
Arkansas	65	$1821.08	$1539.01	4
Massachusetts	64	$2564.15	$1870.82	4
Minnesota	48	$2225.33	$1900.89	3
Missouri	47	$2539.76	$2048.51	3
New Jersey	41	$2758.20	$2076.82	3
Georgia	39	$2072.54	$1551.61	3
Maryland	36	$2736.05	$2081.52	2
Kansas	32	$2437.31	$2098.77	2
Oregon	31	$2606.84	$2072.18	2
Tennessee	30	$2405.82	$2072.14	2
Virginia	29	$2892.40	$2064.44	1
Louisiana	26	$2523.35	$2164.92	2
Nebraska	26	$2271.75	$2064.26	2
Maine	15	$2625.40	$2115.39	1
Rhode Island	14	$2658.74	$2000.87	1
South Carolina	14	$2564.07	$2144.63	1
Wisconsin	13	$2394.54	$2141.55	1
Mississippi	13	$2428.14	$1953.78	1
Colorado	12	$2451.70	$1958.81	1
Kentucky	12	$2423.45	$2185.65	1
West Virginia	12	$2149.47	$1565.65	1
New Hampshire	12	$2556.35	$2051.30	1
Nevada	11	$2623.95	$2140.08	1
District of Columbia	11	$2976.82	$2146.46	1
Connecticut	11	$3058.99	$2143.26	1
Oklahoma	11	$2256.04	$1969.60	1
Iowa	11	$2314.13	$2050.33	1

Related codes

33418Repair of mitral valve through the skin$1401.94
33405Replacement of aortic valve on heart-lung machine$1533.21
33427Radical reconstruction of mitral valve on heart-lung machine$2036.05

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.