CPT code 33418: Mitral valve repair, percutaneous, initial prosthesis2026 Medicare rate & RVUs in Virgin Islands, VI
Reports catheter-based repair of mitral regurgitation using an initial prosthesis, including transseptal access when performed, during a structural heart procedure.
In Virgin Islands, VI, Medicare pays $1,580.25 for 33418 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 33418 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 33418 covers
This code covers a catheter-based mitral valve repair, commonly a transcatheter edge-to-edge procedure for mitral regurgitation. A structural heart team, typically including an interventional cardiologist and cardiac surgeon, performs it in a hospital catheterization laboratory or hybrid operating room. The catheter is advanced to the mitral valve, often through transseptal access, and a prosthesis is used to improve leaflet coaptation. The code includes the transseptal puncture when performed.
Report 33418 for the initial prosthesis; report 33419 for each additional prosthesis. The operative report should support the percutaneous approach, mitral valve repair, and prosthesis use. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
How Virgin Islands, VI compares for 33418
Across 109 of 109 payment localities, the facility rate for 33418 runs from $1,397.26 in Wisconsin to $2,012.87 in Alaska. Virgin Islands, VI pays $1,580.25. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Virgin Islands, VI · this page$1,580.25
- Los Angeles, CA · California$1,592.25+$12.00
- Washington, DC area · District of Columbia$1,715.91+$135.66
- Miami, FL · Florida$1,971.90+$391.65
- Chicago, IL · Illinois$1,911.01+$330.76
- Manhattan, NY · New York$1,839.28+$259.03
- Alaska · Alaska$2,012.87+$432.62
Other areas in United States Virgin Islands first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $1,437.84 |
| ArkansasArkansas | — | $1,420.66 |
| ArizonaArizona | — | $1,536.37 |
| Bakersfield, CACalifornia | — | $1,530.91 |
| Chico, CACalifornia | — | $1,510.69 |
| El Centro, CACalifornia | — | $1,511.93 |
| Fresno, CACalifornia | — | $1,510.69 |
| Hanford, CACalifornia | — | $1,510.69 |
| Madera, CACalifornia | — | $1,510.69 |
| Merced, CACalifornia | — | $1,510.69 |
| Modesto, CACalifornia | — | $1,510.69 |
| Napa, CACalifornia | — | $1,614.78 |
| Oxnard, CACalifornia | — | $1,568.14 |
| Redding, CACalifornia | — | $1,510.69 |
| Rest of CaliforniaCalifornia | — | $1,510.69 |
| Riverside, CACalifornia | — | $1,590.41 |
| Sacramento, CACalifornia | — | $1,549.58 |
| Salinas, CACalifornia | — | $1,543.20 |
| San Diego, CACalifornia | — | $1,554.09 |
| Marin County, CACalifornia | — | $1,662.22 |
| San Francisco, CACalifornia | — | $1,653.78 |
| San Benito County, CACalifornia | — | $1,706.12 |
| Santa Clara County, CACalifornia | — | $1,671.63 |
| San Luis Obispo, CACalifornia | — | $1,522.84 |
| Santa Cruz, CACalifornia | — | $1,548.52 |
| Santa Maria, CACalifornia | — | $1,542.02 |
| Santa Rosa, CACalifornia | — | $1,561.64 |
| Stockton, CACalifornia | — | $1,510.69 |
| Vallejo, CACalifornia | — | $1,602.62 |
| Visalia, CACalifornia | — | $1,510.69 |
| Yuba City, CACalifornia | — | $1,510.69 |
| ColoradoColorado | — | $1,557.20 |
| ConnecticutConnecticut | — | $1,675.74 |
| DelawareDelaware | — | $1,557.66 |
| Fort Lauderdale, FLFlorida | — | $1,785.06 |
| Rest of FloridaFlorida | — | $1,693.26 |
| Atlanta, GAGeorgia | — | $1,638.42 |
| Rest of GeorgiaGeorgia | — | $1,598.00 |
| Hawaii, Guam, HIHawaii | — | $1,515.10 |
| IowaIowa | — | $1,407.20 |
| IdahoIdaho | — | $1,427.47 |
| East St. Louis, ILIllinois | — | $1,809.90 |
| Rest of IllinoisIllinois | — | $1,696.00 |
| Suburban Chicago, ILIllinois | — | $1,787.43 |
| IndianaIndiana | — | $1,432.68 |
| KansasKansas | — | $1,430.65 |
| KentuckyKentucky | — | $1,528.40 |
| New Orleans, LALouisiana | — | $1,597.94 |
| Rest of LouisianaLouisiana | — | $1,537.95 |
| Metropolitan Boston, MAMassachusetts | — | $1,651.44 |
| Rest of MassachusettsMassachusetts | — | $1,562.26 |
| Baltimore area, MDMaryland | — | $1,677.11 |
| Rest of MarylandMaryland | — | $1,574.41 |
| Rest of MaineMaine | — | $1,464.45 |
| Southern Maine, MEMaine | — | $1,486.75 |
| Detroit, MIMichigan | — | $1,741.22 |
| Rest of MichiganMichigan | — | $1,588.29 |
| MinnesotaMinnesota | — | $1,414.35 |
| Metropolitan Kansas City, MOMissouri | — | $1,557.92 |
| Metropolitan St. Louis, MOMissouri | — | $1,567.80 |
| Rest of MissouriMissouri | — | $1,535.42 |
| MississippiMississippi | — | $1,476.82 |
| MontanaMontana | — | $1,580.37 |
| North CarolinaNorth Carolina | — | $1,472.34 |
| North DakotaNorth Dakota | — | $1,433.45 |
| NebraskaNebraska | — | $1,404.75 |
| New HampshireNew Hampshire | — | $1,561.43 |
| Northern New JerseyNew Jersey | — | $1,709.11 |
| Rest of New JerseyNew Jersey | — | $1,672.94 |
| New MexicoNew Mexico | — | $1,607.29 |
| NevadaNevada | — | $1,539.70 |
| NYC suburbs and Long Island, NYNew York | — | $1,914.16 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $1,707.08 |
| Queens, NYNew York | — | $1,809.19 |
| Rest of New YorkNew York | — | $1,493.03 |
| OhioOhio | — | $1,558.27 |
| OklahomaOklahoma | — | $1,495.29 |
| Portland, OROregon | — | $1,565.50 |
| Rest of OregonOregon | — | $1,506.03 |
| Metropolitan Philadelphia, PAPennsylvania | — | $1,659.25 |
| Rest of PennsylvaniaPennsylvania | — | $1,544.04 |
| Puerto RicoPuerto Rico | — | $1,580.25 |
| Rhode IslandRhode Island | — | $1,583.34 |
| South CarolinaSouth Carolina | — | $1,522.16 |
| South DakotaSouth Dakota | — | $1,416.08 |
| TennesseeTennessee | — | $1,440.25 |
| Austin, TXTexas | — | $1,571.06 |
| Beaumont, TXTexas | — | $1,537.81 |
| Brazoria, TXTexas | — | $1,532.13 |
| Dallas, TXTexas | — | $1,553.95 |
| Fort Worth, TXTexas | — | $1,554.35 |
| Galveston, TXTexas | — | $1,544.60 |
| Houston, TXTexas | — | $1,680.60 |
| Rest of TexasTexas | — | $1,542.38 |
| UtahUtah | — | $1,538.60 |
| VirginiaVirginia | — | $1,503.10 |
| VermontVermont | — | $1,455.44 |
| Rest of WashingtonWashington | — | $1,550.18 |
| King County, WAWashington | — | $1,652.10 |
| WisconsinWisconsin | — | $1,397.26 |
| West VirginiaWest Virginia | — | $1,650.81 |
| WyomingWyoming | — | $1,516.34 |
33418 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
How the 33418 rate is calculated
Each of 33418’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 33418
RVUs × geographic indexes × conversion factor
Work31.44
31.44 RVUs× 1.000 GPCI
Practice expense8.46
8.46 RVUs× 1.000 GPCI
Malpractice7.43
7.43 RVUs× 1.000 GPCI
Adjusted RVUs
47.3300
Conversion factor
$33.4009
Medicare rate
$1,580.86
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Virgin Islands, VI inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
3,947
- Code
- 33418
- Physician work
- 31.44
- Practice expense
- 8.46
- Malpractice
- 7.43
GPCI2026.csv
107
- Locality
- Virgin Islands, VI
- Physician work
- 1.000
- Practice expense
- 1.011
- Malpractice
- 0.985
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 31.44 | × 1.000 | 31.4400 |
| Practice expense | 8.46 | × 1.011 | 8.5531 |
| Malpractice | 7.43 | × 0.985 | 7.3185 |
| Total RVUs | 47.3116 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Virgin Islands, VI$1580.25
Facility: (31.44 × 1 + 8.46 × 1.011 + 7.43 × 0.985) × $33.4009 = $1580.25
Payment rules and modifiers for 33418
33418 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33418
Mitral valve repair, percutaneous, initial prosthesis
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.84/0.07 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 33418
Mitral valve repair, percutaneous, initial prosthesis
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
33418 without 51 · national facility
$1,580.86
Mitral valve repair, percutaneous, initial prosthesis
33418-51 · Second procedure: 50%
$790.43
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
How 33418 has changed in Virgin Islands, VI
33418 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2015
RVU15A
No ratechanged toNo rate
Held through RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D, RVU19A, RVU19B, RVU19C, RVU19D, RVU20A, RVU20B, RVU20C, RVU20D, RVU21A, RVU21B, RVU21C, RVU21D, RVU22A, RVU22B, RVU22C, RVU22D, RVU23A, RVU23B, RVU23C, RVU23D, RVU24A, RVU24AR, RVU24B, RVU24C, RVU24D, RVU25A, RVU25B, RVU25C, RVU25D, RVU26A, RVU26B, RVU26C, RVU26D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $1,580.25 | RVU26D |
| 2026-07-01 | Not available in this setting | $1,580.25 | RVU26C |
| 2026-04-01 | Not available in this setting | $1,580.25 | RVU26B |
| 2026-01-01 | Not available in this setting | $1,580.25 | RVU26A |
| 2025-10-01 | Not available in this setting | $1,710.86 | RVU25D |
| 2025-07-01 | Not available in this setting | $1,710.86 | RVU25C |
| 2025-04-01 | Not available in this setting | $1,710.86 | RVU25B |
| 2025-01-01 | Not available in this setting | $1,710.86 | RVU25A |
| 2024-10-01 | Not available in this setting | $1,757.53 | RVU24D |
| 2024-07-01 | Not available in this setting | $1,757.53 | RVU24C |
| 2024-04-01 | Not available in this setting | $1,757.53 | RVU24B |
| 2024-03-09 | Not available in this setting | $1,757.53 | RVU24AR |
| 2024-01-01 | Not available in this setting | $1,728.85 | RVU24A |
| 2023-10-01 | Not available in this setting | $1,779.75 | RVU23D |
| 2023-07-01 | Not available in this setting | $1,780.09 | RVU23C |
| 2023-04-01 | Not available in this setting | $1,780.09 | RVU23B |
| 2023-01-01 | Not available in this setting | $1,780.09 | RVU23A |
| 2022-10-01 | Not available in this setting | $1,828.30 | RVU22D |
| 2022-07-01 | Not available in this setting | $1,828.30 | RVU22C |
| 2022-04-01 | Not available in this setting | $1,828.30 | RVU22B |
| 2022-01-01 | Not available in this setting | $1,828.30 | RVU22A |
| 2021-10-01 | Not available in this setting | $1,832.40 | RVU21D |
| 2021-07-01 | Not available in this setting | $1,832.40 | RVU21C |
| 2021-04-01 | Not available in this setting | $1,832.40 | RVU21B |
| 2021-01-01 | Not available in this setting | $1,832.40 | RVU21A |
| 2020-10-01 | Not available in this setting | $1,883.11 | RVU20D |
| 2020-07-01 | Not available in this setting | $1,883.11 | RVU20C |
| 2020-04-01 | Not available in this setting | $1,883.11 | RVU20B |
| 2020-01-01 | Not available in this setting | $1,883.11 | RVU20A |
| 2019-10-01 | Not available in this setting | $1,888.71 | RVU19D |
| 2019-07-01 | Not available in this setting | $1,888.71 | RVU19C |
| 2019-04-01 | Not available in this setting | $1,888.71 | RVU19B |
| 2019-01-01 | Not available in this setting | $1,888.71 | RVU19A |
| 2018-10-01 | Not available in this setting | $1,884.22 | RVU18D |
| 2018-07-01 | Not available in this setting | $1,884.22 | RVU18C |
| 2018-04-01 | Not available in this setting | $1,884.22 | RVU18B |
| 2018-01-01 | Not available in this setting | $1,884.22 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $1,882.34 | RVU17D |
| 2017-07-01 | Not available in this setting | $1,882.34 | RVU17C |
| 2017-04-01 | Not available in this setting | $1,882.34 | RVU17B |
| 2017-01-01 | Not available in this setting | $1,882.34 | RVU17A |
| 2016-10-01 | Not available in this setting | $1,851.38 | RVU16D |
| 2016-07-01 | Not available in this setting | $1,851.38 | RVU16C |
| 2016-04-01 | Not available in this setting | $1,851.38 | RVU16B |
| 2016-01-01 | Not available in this setting | $1,851.38 | RVU16A |
| 2015-10-01 | Not available in this setting | $1,918.29 | RVU15D |
| 2015-07-01 | Not available in this setting | $1,918.29 | RVU15C |
| 2015-04-01 | Not available in this setting | $1,908.75 | RVU15B |
| 2015-01-01 | Not available in this setting | $1,908.75 | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Virgin Islands, VI rate applies
Virgin Islands, VI is a Medicare payment area, not a city. Our Census mapping connects it to 10 cities and communities in United States Virgin Islands. Some span more than one payment area; confirm with the service ZIP.
- Charlotte Amalie
- Charlotte Amalie East
- Charlotte Amalie West
- Christiansted
- Coral Bay
- Cruz Bay
- Frederiksted
- Frederiksted Southeast
33418 billing questions
When is 33419 reported with 33418?
Report 33418 for the initial prosthesis and 33419 for each additional prosthesis. The operative report should support the number of prostheses used.
Is transseptal puncture separately reported?
Transseptal puncture, when performed for this repair, is included in 33418.
How does 33418 differ from 33425 through 33427?
33418 describes a percutaneous transcatheter repair. Codes 33425 through 33427 describe open surgical mitral valve repair procedures.
Should modifier 50 be appended?
No. Bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What happens when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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