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CPT code 33430: Mitral valve replacement, open surgical replacement2026 Medicare rate & RVUs

Report open surgical replacement when the diseased mitral valve is removed and a prosthetic valve is implanted rather than repaired.

CMS RVU26DEffective Oct 1, 2026109 payment localities9.5K Medicare services in 2024

Medicare pays $2,622.97 for 33430 nationally in a facility.

Medicare rate · 33430

Mitral valve replacement, open surgical replacement

Office or facility?

Work RVUs
49.66
Total RVUs
78.53
Global days
090

National rate · 2026

$2,622.97

Facility setting, before claim adjustments.

See every locality for 33430 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 33430 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 33430 covers

This service replaces the mitral valve during open cardiac surgery, typically using cardiopulmonary bypass. The surgeon removes the diseased valve and implants a prosthetic valve; the operation is generally performed in a hospital operating room by a cardiac surgeon. The operative report should establish that replacement, rather than repair or revision, was performed and identify the valve treated and the implanted prosthesis.

Select this code for mitral valve replacement, not for a procedure that preserves and repairs the native valve. Report other procedures performed in the same session when separately supported; under the standard multiple-procedure rule, the highest-valued procedure is paid in full and the others at 50%. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. An assistant at surgery may be paid. 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.

Where 33430 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

33430 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$2,376.01
AlaskaUnavailable$3,304.69
ArizonaUnavailable$2,546.84
ArkansasUnavailable$2,346.26
Atlanta, GAUnavailable$2,719.07
Austin, TXUnavailable$2,611.84
Bakersfield, CAUnavailable$2,547.80
Baltimore area, MDUnavailable$2,787.01
Beaumont, TXUnavailable$2,543.96
Brazoria, TXUnavailable$2,541.23

33430 rates by state

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

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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.

View every state and territory as a table
33430 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 33430 rate is calculated

Each of 33430’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 · 33430

RVUs × geographic indexes × conversion factor

Office or facility?

Work49.66

49.66 RVUs× 1.000 GPCI

Practice expense16.62

16.62 RVUs× 1.000 GPCI

Malpractice12.25

12.25 RVUs× 1.000 GPCI

Adjusted RVUs

78.5300

Conversion factor

$33.4009

Medicare rate

$2,622.97

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 33430

33430 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 33430

Mitral valve replacement, open surgical replacement

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.84/0.07Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 33430

Mitral valve replacement, open surgical replacement

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

33430 without 51 · national facility

$2,622.97

Mitral valve replacement, open surgical replacement

33430-51 · Second procedure: 50%

$1,311.49

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

33430 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 33430

    Mitral valve replacement, open surgical replacement49.66 wRVU

    Not priced

  • 33425

    Mitral valve repair, without prosthetic ring48.71 wRVU

    Not priced

  • 33427

    Mitral valve repair, congenital valve repair43.71 wRVU

    Not priced

  • 33418

    Mitral valve repair, percutaneous, initial prosthesis31.44 wRVU

    Not priced

  • 33405

    Aortic valve replacement, standard prosthetic valve40.29 wRVU

    Not priced

How to choose

33425Mitral valve repairWithout prosthetic ring
33430 replaces the mitral valve with a prosthesis. 33425 is for mitral valve repair with bypass when the surgeon preserves the native valve.
33427Mitral valve repairCongenital valve repair
Choose 33430 for valve replacement. 33427 describes mitral valve reconstruction, not implantation of a replacement valve.
33418Mitral valve repairPercutaneous, initial prosthesis
33430 is open surgical replacement. 33418 describes catheter-based mitral valve repair rather than open replacement.
33405Aortic valve replacementStandard prosthetic valve
33405 concerns replacement of the aortic valve; 33430 is specific to replacement of the mitral valve.

Codes related to 33430

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

Codes related to 33430
CodeHow it relatesNational office range
Used instead
33425Mitral valve repair, without prosthetic ringMitral valve repair with bypass; use when the native valve is repaired instead of replaced.No office rate
33426Mitral valve repair, with prosthetic ringMitral valve repair with bypass; describes repair rather than prosthetic valve replacement.No office rate
33427Mitral valve repair, congenital valve repairMitral valve reconstruction with bypass, when the native valve is reconstructed rather than replaced.No office rate
33418Mitral valve repair, percutaneous, initial prosthesisCatheter-based mitral valve repair, a different approach for selected patients.No office rate

33430 billing questions

How is replacement distinguished from mitral valve repair?

Use 33430 when the surgeon replaces the mitral valve with a prosthesis. Codes such as 33425–33427 describe mitral valve repair procedures that preserve the native valve.

What operative documentation supports 33430?

The operative report should document replacement of the mitral valve, rather than repair or revision, and identify the implanted prosthesis and any other procedures performed.

How are other procedures in the same session paid?

When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the other procedures are subject to the standard 50% multiple-procedure reduction.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

What care is included in the global period?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

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 33430PPRRVU2026_Oct_nonQPP.csv, line 3,956 (RVU26D)

Open CMS sourceHow we calculate rates

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