CPT code 33426: Mitral valve repair, with prosthetic ring2026 Medicare rate & RVUs in North Carolina

Open mitral valve repair with a prosthetic annuloplasty ring on cardiopulmonary bypass, reported when the native valve is repaired rather than replaced.

CMS RVU26DEffective Oct 1, 2026One payment locality2.9K Medicare services in 2024

In North Carolina, Medicare pays $2,074.33 for 33426 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)

$2,074.33Hospital or facility

Check a contract rate as a % of Medicare · 33426 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

Rate in North Carolina
What 33426 covers
Compared with other areas
Rate map
How it’s calculated
Payment rules
Related codes
Rate history
Where it applies
Billing questions
Sources

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.

How North Carolina compares for 33426

Across 109 of 109 payment localities, the facility rate for 33426 runs from $1,970.87 in Wisconsin to $2,811.00 in Alaska. North Carolina pays $2,074.33. The RVUs are the same everywhere; the geographic indexes change the dollars.

33426 in North Carolina vs other payment areas

North Carolina · this page$2,074.33
Los Angeles, CA · California$2,259.32+$184.99
Washington, DC area · District of Columbia$2,431.69+$357.36
Miami, FL · Florida$2,783.94+$709.61
Chicago, IL · Illinois$2,695.23+$620.90
Manhattan, NY · New York$2,602.98+$528.65
Alaska · Alaska$2,811.00+$736.67

Other areas in North Carolina first, then benchmark localities. Bars start at $0.

Every other payment area

33426 in every other Medicare payment locality
Payment locality	Office	Facility
AlabamaAlabama	—	$2,021.41
ArkansasArkansas	—	$1,996.06
ArizonaArizona	—	$2,166.99
Bakersfield, CACalifornia	—	$2,167.92
Chico, CACalifornia	—	$2,139.67
El Centro, CACalifornia	—	$2,141.41
Fresno, CACalifornia	—	$2,139.67
Hanford, CACalifornia	—	$2,139.67
Madera, CACalifornia	—	$2,139.67
Merced, CACalifornia	—	$2,139.67
Modesto, CACalifornia	—	$2,139.67
Napa, CACalifornia	—	$2,299.97
Oxnard, CACalifornia	—	$2,226.24
Redding, CACalifornia	—	$2,139.67
Rest of CaliforniaCalifornia	—	$2,139.67
Riverside, CACalifornia	—	$2,251.51
Sacramento, CACalifornia	—	$2,198.20
Salinas, CACalifornia	—	$2,189.26
San Diego, CACalifornia	—	$2,207.48
Marin County, CACalifornia	—	$2,371.61
San Francisco, CACalifornia	—	$2,359.76
San Benito County, CACalifornia	—	$2,434.74
Santa Clara County, CACalifornia	—	$2,386.32
San Luis Obispo, CACalifornia	—	$2,160.05
Santa Cruz, CACalifornia	—	$2,201.70
Santa Maria, CACalifornia	—	$2,188.35
Santa Rosa, CACalifornia	—	$2,220.55
Stockton, CACalifornia	—	$2,139.67
Vallejo, CACalifornia	—	$2,282.90
Visalia, CACalifornia	—	$2,139.67
Yuba City, CACalifornia	—	$2,139.67
ColoradoColorado	—	$2,202.80
ConnecticutConnecticut	—	$2,369.69
DelawareDelaware	—	$2,198.02
Fort Lauderdale, FLFlorida	—	$2,519.49
Rest of FloridaFlorida	—	$2,386.22
Atlanta, GAGeorgia	—	$2,313.68
Rest of GeorgiaGeorgia	—	$2,247.55
Hawaii, Guam, HIHawaii	—	$2,150.12
IowaIowa	—	$1,981.49
IdahoIdaho	—	$2,010.34
East St. Louis, ILIllinois	—	$2,547.18
Rest of IllinoisIllinois	—	$2,386.75
Suburban Chicago, ILIllinois	—	$2,523.45
IndianaIndiana	—	$2,018.19
KansasKansas	—	$2,013.56
KentuckyKentucky	—	$2,149.63
New Orleans, LALouisiana	—	$2,251.26
Rest of LouisianaLouisiana	—	$2,162.71
Metropolitan Boston, MAMassachusetts	—	$2,343.27
Rest of MassachusettsMassachusetts	—	$2,208.80
Baltimore area, MDMaryland	—	$2,371.56
Rest of MarylandMaryland	—	$2,223.06
Rest of MaineMaine	—	$2,062.25
Southern Maine, MEMaine	—	$2,099.03
Detroit, MIMichigan	—	$2,454.24
Rest of MichiganMichigan	—	$2,235.55
MinnesotaMinnesota	—	$2,000.34
Metropolitan Kansas City, MOMissouri	—	$2,194.92
Metropolitan St. Louis, MOMissouri	—	$2,209.79
Rest of MissouriMissouri	—	$2,157.38
MississippiMississippi	—	$2,075.04
MontanaMontana	—	$2,231.15
North DakotaNorth Dakota	—	$2,024.92
NebraskaNebraska	—	$1,978.67
New HampshireNew Hampshire	—	$2,207.73
Northern New JerseyNew Jersey	—	$2,420.17
Rest of New JerseyNew Jersey	—	$2,365.63
New MexicoNew Mexico	—	$2,262.53
NevadaNevada	—	$2,174.14
NYC suburbs and Long Island, NYNew York	—	$2,710.19
Poughkeepsie and northern NYC suburbs, NYNew York	—	$2,413.46
Queens, NYNew York	—	$2,562.30
Rest of New YorkNew York	—	$2,104.68
OhioOhio	—	$2,193.40
OklahomaOklahoma	—	$2,103.45
Portland, OROregon	—	$2,217.83
Rest of OregonOregon	—	$2,126.49
Metropolitan Philadelphia, PAPennsylvania	—	$2,343.89
Rest of PennsylvaniaPennsylvania	—	$2,173.82
Puerto RicoPuerto Rico	—	$2,231.84
Rhode IslandRhode Island	—	$2,236.65
South CarolinaSouth Carolina	—	$2,143.57
South DakotaSouth Dakota	—	$2,000.53
TennesseeTennessee	—	$2,027.42
Austin, TXTexas	—	$2,222.44
Beaumont, TXTexas	—	$2,164.46
Brazoria, TXTexas	—	$2,162.22
Dallas, TXTexas	—	$2,193.17
Fort Worth, TXTexas	—	$2,192.96
Galveston, TXTexas	—	$2,179.89
Houston, TXTexas	—	$2,370.79
Rest of TexasTexas	—	$2,173.88
UtahUtah	—	$2,167.88
VirginiaVirginia	—	$2,121.37
Virgin Islands, VIUnited States Virgin Islands	—	$2,231.84
VermontVermont	—	$2,055.01
Rest of WashingtonWashington	—	$2,192.03
King County, WAWashington	—	$2,346.16
WisconsinWisconsin	—	$1,970.87
West VirginiaWest Virginia	—	$2,319.91
WyomingWyoming	—	$2,141.27

33426 rates by state

Office rate range in each state. Select a state to see its payment localities.

ME WI VT NH MT ND MN MI NY MA RI WA ID WY SD IA IL IN OH PA NJ CT OR NV UT CO NE MO KY WV VA MD DE CA AZ NM KS OK AR TN NC SC DC TX LA MS AL GA FL AK HI

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

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33426 office rate range by state
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

See 33426 in every payment locality

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

Office or facility?

Your ZIP

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.

The exact North Carolina inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,953

Code: 33426
Physician work: 42.20
Practice expense: 14.19
Malpractice: 10.43

GPCI2026.csv

Locality: North Carolina
Physician work: 1.000
Practice expense: 0.933
Malpractice: 0.639

Facility calculation for 33426 in North Carolina
Component	RVU	Locality factor	Adjusted
Physician work	42.20	× 1.000	42.2000
Practice expense	14.19	× 0.933	13.2393
Malpractice	10.43	× 0.639	6.6648
Total RVUs			62.1040
Conversion factor			× 33.4009

Facility rate, North Carolina$2074.33

Facility: (42.2 × 1 + 14.19 × 0.933 + 10.43 × 0.639) × $33.4009 = $2074.33

Open 33426 in the RVU calculator

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

Date of surgery

Date of a later visit

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.

24Unrelated E/M visit by the same physician
79Unrelated procedure (starts its own global period)
58Staged, more extensive, or therapy procedure that was planned
78Unplanned return to the operating room for a related complication

SurgeryVisit

Sep 23, 2026Jan 10, 2027

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%).

When to use modifier 51

Codes related to 33426

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 33426
Code	How it relates	Office range, North Carolina
Same family
33425	Mitral valve repair, without prosthetic ringRelated open mitral repair on bypass performed without a prosthetic ring.	No office rate
33427	Mitral valve repair, congenital valve repairFor extensive mitral reconstruction; distinguish the operative technique documented.	No office rate
Used instead
33418	Mitral valve repair, percutaneous, initial prosthesisCatheter-based mitral repair is an alternative to open repair with an annuloplasty ring.	No office rate
33430	Mitral valve replacement, open surgical replacementUse for mitral valve replacement rather than repair of the native valve.	No office rate

How 33426 has changed in North Carolina

33426 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

Compare with release effective

A rate is unavailable in one of these releases, so a change cannot be calculated.

Base rate by release · bars start at $0 · select a bar to compare

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

Rates in every CMS release
Effective from	Office	Facility	CMS release
2026-10-01	Not available in this setting	$2,074.33	RVU26D
2026-07-01	Not available in this setting	$2,074.33	RVU26C
2026-04-01	Not available in this setting	$2,074.33	RVU26B
2026-01-01	Not available in this setting	$2,074.33	RVU26A
2025-10-01	Not available in this setting	$2,123.61	RVU25D
2025-07-01	Not available in this setting	$2,123.61	RVU25C
2025-04-01	Not available in this setting	$2,123.61	RVU25B
2025-01-01	Not available in this setting	$2,123.61	RVU25A
2024-10-01	Not available in this setting	$2,176.33	RVU24D
2024-07-01	Not available in this setting	$2,176.33	RVU24C
2024-04-01	Not available in this setting	$2,176.33	RVU24B
2024-03-09	Not available in this setting	$2,176.33	RVU24AR
2024-01-01	Not available in this setting	$2,140.81	RVU24A
2023-10-01	Not available in this setting	$2,236.28	RVU23D
2023-07-01	Not available in this setting	$2,236.28	RVU23C
2023-04-01	Not available in this setting	$2,236.28	RVU23B
2023-01-01	Not available in this setting	$2,236.28	RVU23A
2022-10-01	Not available in this setting	$2,312.75	RVU22D
2022-07-01	Not available in this setting	$2,312.75	RVU22C
2022-04-01	Not available in this setting	$2,312.75	RVU22B
2022-01-01	Not available in this setting	$2,312.75	RVU22A
2021-10-01	Not available in this setting	$2,322.53	RVU21D
2021-07-01	Not available in this setting	$2,322.53	RVU21C
2021-04-01	Not available in this setting	$2,322.53	RVU21B
2021-01-01	Not available in this setting	$2,322.53	RVU21A
2020-10-01	Not available in this setting	$2,364.15	RVU20D
2020-07-01	Not available in this setting	$2,364.15	RVU20C
2020-04-01	Not available in this setting	$2,364.15	RVU20B
2020-01-01	Not available in this setting	$2,364.15	RVU20A
2019-10-01	Not available in this setting	$2,338.55	RVU19D
2019-07-01	Not available in this setting	$2,338.55	RVU19C
2019-04-01	Not available in this setting	$2,338.55	RVU19B
2019-01-01	Not available in this setting	$2,338.55	RVU19A
2018-10-01	Not available in this setting	$2,335.42	RVU18D
2018-07-01	Not available in this setting	$2,335.42	RVU18C
2018-04-01	Not available in this setting	$2,335.42	RVU18B
2018-01-01	Not available in this setting	$2,335.42	RVU18AR1
2017-10-01	Not available in this setting	$2,347.55	RVU17D
2017-07-01	Not available in this setting	$2,347.55	RVU17C
2017-04-01	Not available in this setting	$2,347.55	RVU17B
2017-01-01	Not available in this setting	$2,347.55	RVU17A
2016-10-01	Not available in this setting	$2,359.73	RVU16D
2016-07-01	Not available in this setting	$2,359.73	RVU16C
2016-04-01	Not available in this setting	$2,359.73	RVU16B
2016-01-01	Not available in this setting	$2,359.73	RVU16A
2015-10-01	Not available in this setting	$2,365.81	RVU15D
2015-07-01	Not available in this setting	$2,365.81	RVU15C
2015-04-01	Not available in this setting	$2,354.03	RVU15B
2015-01-01	Not available in this setting	$2,354.03	RVU15A
2014-10-01	Not available in this setting	$2,355.37	RVU14D
2014-07-01	Not available in this setting	$2,355.37	RVU14C
2014-04-01	Not available in this setting	$2,355.37	RVU14B
2014-01-01	Not available in this setting	$2,355.37	RVU14A
2013-10-01	Not available in this setting	$2,289.53	RVU13D
2013-07-01	Not available in this setting	$2,289.53	RVU13C
2013-04-01	Not available in this setting	$2,289.53	RVU13B
2013-01-01	Not available in this setting	$2,289.53	RVU13AR

Price 33426 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

Aberdeen
Advance
Ahoskie
Alamance
Albemarle
Alexis
Alliance
Altamahaw

Browse all communities in North Carolina

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

RVUs for 33426PPRRVU2026_Oct_nonQPP.csv, line 3,953 (RVU26D)

3,95033420,,[CPT descriptor omitted],A,,25.15,10.36,NA,10.36,,6.02,41.53,41.53,0,090,0.09,0.84,0.07,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00

3,95133422,,[CPT descriptor omitted],A,,28.99,11.60,NA,11.60,,6.96,47.55,47.55,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00

3,95233425,,[CPT descriptor omitted],A,,48.71,15.64,NA,15.64,,11.99,76.34,76.34,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00

3,95333426,,[CPT descriptor omitted],A,,42.20,14.19,NA,14.19,,10.43,66.82,66.82,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00

3,95433427,,[CPT descriptor omitted],A,,43.71,13.84,NA,13.84,,10.51,68.06,68.06,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00

3,9553342F,,[CPT descriptor omitted],I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00

3,95633430,,[CPT descriptor omitted],A,,49.66,16.62,NA,16.62,,12.25,78.53,78.53,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00

Geographic factors for North CarolinaGPCI2026.csv, line 83 (RVU26D)

8013202,NY,03,POUGHKPSIE/N NYC SUBURBS,1.045,1.095,1.210

8113292,NY,04,QUEENS,1.064,1.182,1.442

8213282,NY,99,REST OF NEW YORK,1.000,0.950,0.703

8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639

8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406

8515202,OH,00,OHIO,1.000,0.913,1.008

8604312,OK,00,OKLAHOMA,1.000,0.893,0.777

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What 33426 covers

How North Carolina compares for 33426

Every other payment area

33426 rates by state

How the 33426 rate is calculated

Payment rules and modifiers for 33426

What modifiers do to the payment

Codes related to 33426

How 33426 has changed in North Carolina

Where the North Carolina rate applies

33426 billing questions

How is this code distinguished from 33425?

Is cardiopulmonary bypass separately reported?

Can an assistant surgeon or co-surgeon be reported?

What does the 90-day global period include?

Should modifier 50 or separate right- and left-sided units be used?

How are other procedures in the same session paid?

Where these rates come from

Did this answer your question about what 33426 pays in North Carolina?

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