CPT code 33427: Mitral valve repair, congenital valve repair2026 Medicare rate & RVUs in Washington, DC area
Open surgical repair of a congenitally abnormal mitral valve is reported when the surgeon reconstructs the valve during an operation using cardiopulmonary bypass.
In Washington, DC area, Medicare pays $2,474.05 for 33427 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 33427 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 33427 covers
This code represents open surgical repair of a congenitally abnormal mitral valve during an operation using cardiopulmonary bypass. A cardiac surgeon may reconstruct the valve to address congenital leaflet or supporting-structure abnormalities while preserving the patient's native valve. The service is typically performed in a hospital operating room for patients with congenital mitral valve disease; it is distinct from transcatheter repair and valve replacement.
Select the code based on the operation actually performed and documentation identifying the congenital mitral valve problem and repair. The operative report should describe the valve reconstruction and use of bypass. This major surgery includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Report one service for the mitral repair; modifier 50 is not appropriate.
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 Washington, DC area compares for 33427
Across 109 of 109 payment localities, the facility rate for 33427 runs from $2,010.93 in Wisconsin to $2,875.67 in Alaska. Washington, DC area pays $2,474.05. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Washington, DC area · this page$2,474.05
- Los Angeles, CA · California$2,299.77−$174.28
- Miami, FL · Florida$2,828.96+$354.91
- Chicago, IL · Illinois$2,740.40+$266.35
- Manhattan, NY · New York$2,647.30+$173.25
- Alaska · Alaska$2,875.67+$401.62
- Alabama · Alabama$2,063.13−$410.92
Other areas in District of Columbia first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| ArkansasArkansas | — | $2,037.83 |
| ArizonaArizona | — | $2,208.38 |
| Bakersfield, CACalifornia | — | $2,208.12 |
| Chico, CACalifornia | — | $2,179.58 |
| El Centro, CACalifornia | — | $2,181.33 |
| Fresno, CACalifornia | — | $2,179.58 |
| Hanford, CACalifornia | — | $2,179.58 |
| Madera, CACalifornia | — | $2,179.58 |
| Merced, CACalifornia | — | $2,179.58 |
| Modesto, CACalifornia | — | $2,179.58 |
| Napa, CACalifornia | — | $2,339.53 |
| Oxnard, CACalifornia | — | $2,265.93 |
| Redding, CACalifornia | — | $2,179.58 |
| Rest of CaliforniaCalifornia | — | $2,179.58 |
| Riverside, CACalifornia | — | $2,292.32 |
| Sacramento, CACalifornia | — | $2,238.29 |
| Salinas, CACalifornia | — | $2,229.14 |
| San Diego, CACalifornia | — | $2,246.89 |
| Marin County, CACalifornia | — | $2,411.58 |
| San Francisco, CACalifornia | — | $2,399.64 |
| San Benito County, CACalifornia | — | $2,475.30 |
| Santa Clara County, CACalifornia | — | $2,426.50 |
| San Luis Obispo, CACalifornia | — | $2,199.46 |
| Santa Cruz, CACalifornia | — | $2,240.43 |
| Santa Maria, CACalifornia | — | $2,228.00 |
| Santa Rosa, CACalifornia | — | $2,259.58 |
| Stockton, CACalifornia | — | $2,179.58 |
| Vallejo, CACalifornia | — | $2,322.33 |
| Visalia, CACalifornia | — | $2,179.58 |
| Yuba City, CACalifornia | — | $2,179.58 |
| ColoradoColorado | — | $2,243.49 |
| ConnecticutConnecticut | — | $2,411.78 |
| DelawareDelaware | — | $2,239.56 |
| Fort Lauderdale, FLFlorida | — | $2,562.92 |
| Rest of FloridaFlorida | — | $2,429.50 |
| Atlanta, GAGeorgia | — | $2,355.60 |
| Rest of GeorgiaGeorgia | — | $2,290.74 |
| Hawaii, Guam, HIHawaii | — | $2,188.81 |
| IowaIowa | — | $2,022.29 |
| IdahoIdaho | — | $2,051.28 |
| East St. Louis, ILIllinois | — | $2,592.24 |
| Rest of IllinoisIllinois | — | $2,430.69 |
| Suburban Chicago, ILIllinois | — | $2,566.97 |
| IndianaIndiana | — | $2,059.08 |
| KansasKansas | — | $2,054.77 |
| KentuckyKentucky | — | $2,192.11 |
| New Orleans, LALouisiana | — | $2,293.73 |
| Rest of LouisianaLouisiana | — | $2,205.36 |
| Metropolitan Boston, MAMassachusetts | — | $2,384.19 |
| Rest of MassachusettsMassachusetts | — | $2,249.86 |
| Baltimore area, MDMaryland | — | $2,413.57 |
| Rest of MarylandMaryland | — | $2,264.63 |
| Rest of MaineMaine | — | $2,103.59 |
| Southern Maine, MEMaine | — | $2,139.57 |
| Detroit, MIMichigan | — | $2,497.90 |
| Rest of MichiganMichigan | — | $2,278.33 |
| MinnesotaMinnesota | — | $2,039.54 |
| Metropolitan Kansas City, MOMissouri | — | $2,236.99 |
| Metropolitan St. Louis, MOMissouri | — | $2,251.78 |
| Rest of MissouriMissouri | — | $2,200.35 |
| MississippiMississippi | — | $2,117.39 |
| MontanaMontana | — | $2,272.56 |
| North CarolinaNorth Carolina | — | $2,115.57 |
| North DakotaNorth Dakota | — | $2,064.75 |
| NebraskaNebraska | — | $2,019.32 |
| New HampshireNew Hampshire | — | $2,248.34 |
| Northern New JerseyNew Jersey | — | $2,463.08 |
| Rest of New JerseyNew Jersey | — | $2,408.24 |
| New MexicoNew Mexico | — | $2,305.46 |
| NevadaNevada | — | $2,215.10 |
| NYC suburbs and Long Island, NYNew York | — | $2,754.92 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $2,456.60 |
| Queens, NYNew York | — | $2,606.00 |
| Rest of New YorkNew York | — | $2,145.89 |
| OhioOhio | — | $2,235.86 |
| OklahomaOklahoma | — | $2,145.52 |
| Portland, OROregon | — | $2,258.07 |
| Rest of OregonOregon | — | $2,167.16 |
| Metropolitan Philadelphia, PAPennsylvania | — | $2,386.25 |
| Rest of PennsylvaniaPennsylvania | — | $2,216.05 |
| Puerto RicoPuerto Rico | — | $2,273.08 |
| Rhode IslandRhode Island | — | $2,278.35 |
| South CarolinaSouth Carolina | — | $2,185.48 |
| South DakotaSouth Dakota | — | $2,040.17 |
| TennesseeTennessee | — | $2,068.67 |
| Austin, TXTexas | — | $2,262.98 |
| Beaumont, TXTexas | — | $2,206.74 |
| Brazoria, TXTexas | — | $2,203.55 |
| Dallas, TXTexas | — | $2,234.71 |
| Fort Worth, TXTexas | — | $2,234.65 |
| Galveston, TXTexas | — | $2,221.33 |
| Houston, TXTexas | — | $2,413.70 |
| Rest of TexasTexas | — | $2,215.64 |
| UtahUtah | — | $2,209.72 |
| VirginiaVirginia | — | $2,162.20 |
| Virgin Islands, VIUnited States Virgin Islands | — | $2,273.08 |
| VermontVermont | — | $2,095.23 |
| Rest of WashingtonWashington | — | $2,232.85 |
| King County, WAWashington | — | $2,386.96 |
| WisconsinWisconsin | — | $2,010.93 |
| West VirginiaWest Virginia | — | $2,364.01 |
| WyomingWyoming | — | $2,181.99 |
33427 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 33427 rate is calculated
Each of 33427’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 · 33427
RVUs × geographic indexes × conversion factor
Work43.71
43.71 RVUs× 1.000 GPCI
Practice expense13.84
13.84 RVUs× 1.000 GPCI
Malpractice10.51
10.51 RVUs× 1.000 GPCI
Adjusted RVUs
68.0600
Conversion factor
$33.4009
Medicare rate
$2,273.27
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Washington, DC area inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
3,954
- Code
- 33427
- Physician work
- 43.71
- Practice expense
- 13.84
- Malpractice
- 10.51
GPCI2026.csv
39
- Locality
- Washington, DC area
- Physician work
- 1.054
- Practice expense
- 1.178
- Malpractice
- 1.113
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 43.71 | × 1.054 | 46.0703 |
| Practice expense | 13.84 | × 1.178 | 16.3035 |
| Malpractice | 10.51 | × 1.113 | 11.6976 |
| Total RVUs | 74.0715 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Washington, DC area$2474.05
Facility: (43.71 × 1.054 + 13.84 × 1.178 + 10.51 × 1.113) × $33.4009 = $2474.05
Payment rules and modifiers for 33427
33427 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33427
Mitral valve repair, congenital valve repair
| 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 · 33427
Mitral valve repair, congenital valve repair
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
33427 without 51 · national facility
$2,273.27
Mitral valve repair, congenital valve repair
33427-51 · Second procedure: 50%
$1,136.64
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 33427 has changed in Washington, DC area
33427 · 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
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $2,474.05 | RVU26D |
| 2026-07-01 | Not available in this setting | $2,474.05 | RVU26C |
| 2026-04-01 | Not available in this setting | $2,474.05 | RVU26B |
| 2026-01-01 | Not available in this setting | $2,474.05 | RVU26A |
| 2025-10-01 | Not available in this setting | $2,568.10 | RVU25D |
| 2025-07-01 | Not available in this setting | $2,568.10 | RVU25C |
| 2025-04-01 | Not available in this setting | $2,568.10 | RVU25B |
| 2025-01-01 | Not available in this setting | $2,568.10 | RVU25A |
| 2024-10-01 | Not available in this setting | $2,633.56 | RVU24D |
| 2024-07-01 | Not available in this setting | $2,633.56 | RVU24C |
| 2024-04-01 | Not available in this setting | $2,633.56 | RVU24B |
| 2024-03-09 | Not available in this setting | $2,633.56 | RVU24AR |
| 2024-01-01 | Not available in this setting | $2,590.58 | RVU24A |
| 2023-10-01 | Not available in this setting | $2,701.89 | RVU23D |
| 2023-07-01 | Not available in this setting | $2,701.89 | RVU23C |
| 2023-04-01 | Not available in this setting | $2,701.89 | RVU23B |
| 2023-01-01 | Not available in this setting | $2,701.89 | RVU23A |
| 2022-10-01 | Not available in this setting | $2,796.04 | RVU22D |
| 2022-07-01 | Not available in this setting | $2,796.04 | RVU22C |
| 2022-04-01 | Not available in this setting | $2,796.04 | RVU22B |
| 2022-01-01 | Not available in this setting | $2,796.04 | RVU22A |
| 2021-10-01 | Not available in this setting | $2,806.66 | RVU21D |
| 2021-07-01 | Not available in this setting | $2,806.66 | RVU21C |
| 2021-04-01 | Not available in this setting | $2,806.66 | RVU21B |
| 2021-01-01 | Not available in this setting | $2,806.66 | RVU21A |
| 2020-10-01 | Not available in this setting | $2,860.52 | RVU20D |
| 2020-07-01 | Not available in this setting | $2,860.52 | RVU20C |
| 2020-04-01 | Not available in this setting | $2,860.52 | RVU20B |
| 2020-01-01 | Not available in this setting | $2,860.52 | RVU20A |
| 2019-10-01 | Not available in this setting | $2,836.58 | RVU19D |
| 2019-07-01 | Not available in this setting | $2,836.58 | RVU19C |
| 2019-04-01 | Not available in this setting | $2,836.58 | RVU19B |
| 2019-01-01 | Not available in this setting | $2,836.58 | RVU19A |
| 2018-10-01 | Not available in this setting | $2,830.55 | RVU18D |
| 2018-07-01 | Not available in this setting | $2,830.55 | RVU18C |
| 2018-04-01 | Not available in this setting | $2,830.55 | RVU18B |
| 2018-01-01 | Not available in this setting | $2,830.55 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $2,841.26 | RVU17D |
| 2017-07-01 | Not available in this setting | $2,841.26 | RVU17C |
| 2017-04-01 | Not available in this setting | $2,841.26 | RVU17B |
| 2017-01-01 | Not available in this setting | $2,841.26 | RVU17A |
| 2016-10-01 | Not available in this setting | $2,849.37 | RVU16D |
| 2016-07-01 | Not available in this setting | $2,849.37 | RVU16C |
| 2016-04-01 | Not available in this setting | $2,849.37 | RVU16B |
| 2016-01-01 | Not available in this setting | $2,849.37 | RVU16A |
| 2015-10-01 | Not available in this setting | $2,857.30 | RVU15D |
| 2015-07-01 | Not available in this setting | $2,857.30 | RVU15C |
| 2015-04-01 | Not available in this setting | $2,843.08 | RVU15B |
| 2015-01-01 | Not available in this setting | $2,843.08 | RVU15A |
| 2014-10-01 | Not available in this setting | $2,832.71 | RVU14D |
| 2014-07-01 | Not available in this setting | $2,832.71 | RVU14C |
| 2014-04-01 | Not available in this setting | $2,832.71 | RVU14B |
| 2014-01-01 | Not available in this setting | $2,832.71 | RVU14A |
| 2013-10-01 | Not available in this setting | $2,746.07 | RVU13D |
| 2013-07-01 | Not available in this setting | $2,746.07 | RVU13C |
| 2013-04-01 | Not available in this setting | $2,746.07 | RVU13B |
| 2013-01-01 | Not available in this setting | $2,746.07 | RVU13AR |
Where the Washington, DC area rate applies
Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.
- Washington
33427 billing questions
How is this code distinguished from 33425 and 33426?
This code is for the congenital mitral valve repair service. Codes 33425 and 33426 describe other mitral valve repair approaches, distinguished by whether a prosthetic ring is used; select based on the documented operation and applicable descriptor.
When is 33430 reported instead?
Use 33430 when the mitral valve is replaced rather than repaired. This code represents reconstruction of the patient's native valve.
Can the surgeon report a separate preoperative visit or routine postoperative visits?
The global period includes the day-before preoperative visit and 90 days of related postoperative care. Those included services are not separately reported as routine care for this operation.
Can modifier 50 be used for this repair?
No. Report the mitral repair once; modifier 50 is not appropriate for this descriptor and anatomy.
When can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation, while team surgery is not permitted.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures 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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