CPT code 33426: Mitral valve repair, with prosthetic ring2026 Medicare rate & RVUs in Florida
Open mitral valve repair with a prosthetic annuloplasty ring on cardiopulmonary bypass, reported when the native valve is repaired rather than replaced.
CMS doesn’t publish an office rate for 33426 in Florida.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 33426 covers
A cardiac surgeon uses this service for open repair of the native mitral valve on cardiopulmonary bypass, placing a prosthetic ring to reshape or support the valve annulus. It is used for conditions such as mitral regurgitation when the surgeon repairs the valve rather than replacing it. The operation is generally performed in a hospital operating room; the ring placement is part of the repair service.
Select this code when the operative report documents mitral valve repair with a prosthetic ring. Repair without a ring is coded differently, and extensive reconstruction has a separate code. The service has a 90-day global period that includes the day-before preoperative visit and related postoperative care for 90 days. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures receive the standard multiple-procedure reduction. Modifier 50 is inappropriate for this single-valve service. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation. CMS does not permit team-surgery payment for this code.
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.
Where 33426 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale, FL | Unavailable | $2,519.49 |
| Miami, FL | Unavailable | $2,783.94 |
| Rest of Florida | Unavailable | $2,386.22 |
How the 33426 rate is calculated
Each of 33426’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 · 33426
RVUs × geographic indexes × conversion factor
Work42.20
42.20 RVUs× 1.000 GPCI
Practice expense14.19
14.19 RVUs× 1.000 GPCI
Malpractice10.43
10.43 RVUs× 1.000 GPCI
Adjusted RVUs
66.8200
Conversion factor
$33.4009
Medicare rate
$2,231.85
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33426
33426 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33426
Mitral valve repair, with prosthetic ring
| 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 · 33426
Mitral valve repair, with prosthetic ring
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
33426 without 51 · national facility
$2,231.85
Mitral valve repair, with prosthetic ring
33426-51 · Second procedure: 50%
$1,115.93
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%).
33426 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 33425Mitral valve repairWithout prosthetic ring
- Both describe open mitral repair on bypass. Choose 33426 when a prosthetic ring is used; choose 33425 when the repair is performed without one.
- 33427Mitral valve repairCongenital valve repair
- This code identifies repair with a prosthetic ring. Code 33427 is for extensive reconstruction, based on the operative technique documented.
- 33430Mitral valve replacementOpen surgical replacement
- 33426 preserves and repairs the native mitral valve with a ring. Use 33430 when the operation replaces the valve instead.
- 33418Mitral valve repairPercutaneous, initial prosthesis
- 33418 is a catheter-based mitral repair approach. This code is for open repair on cardiopulmonary bypass with a prosthetic ring.
33426 billing questions
How is this code distinguished from 33425?
Use this code when the mitral repair includes a prosthetic annuloplasty ring. Code 33425 describes the related repair without a ring.
Is cardiopulmonary bypass separately reported?
The repair service is performed on cardiopulmonary bypass; bypass is part of this operative service, not a separate unit of mitral repair.
Can an assistant surgeon or co-surgeon be reported?
CMS permits assistant-at-surgery payment for this code. Co-surgeon payment requires supporting documentation, and team-surgery payment is unavailable.
What does the 90-day global period include?
It includes the day-before preoperative visit and 90 days of related postoperative care. The global period is tied to the repair operation.
Should modifier 50 or separate right- and left-sided units be used?
No. This is a single mitral-valve operation, not a bilateral procedure; modifier 50 and separate side-based units are inappropriate.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard multiple-procedure 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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