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Billing code 33425: Mitral valve repairMedicare rate & RVUs

Reports open surgical repair of the native mitral valve using cardiopulmonary bypass when the repair is performed without a prosthetic ring.

CMS RVU26DEffective Oct 1, 2026109 payment localities405 Medicare services in 2024

Medicare pays $2,549.82 for 33425 nationally in a facility.

Medicare rate · 33425

Mitral valve repair

Swap in your local Medicare rate.

Work RVUs
48.71
Total RVUs
76.34
Global days
090

National rate · 2026

$2,549.82

Facility setting, before claim adjustments.

See every locality for 33425 → · 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.

On this page 10 sections
  1. Medicare rate
  2. What 33425 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 33425 covers

A cardiac surgeon reports this service for open repair of a patient’s native mitral valve with cardiopulmonary bypass and without a prosthetic ring. Repair may address valve dysfunction through techniques involving the leaflets or supporting structures. It is typically performed in a hospital operating room; the operative report should establish the valve treated, the repair performed, use of bypass, and whether a ring was implanted.

Select this code when the documented repair is performed without a ring; use the ring-specific sibling when a prosthetic ring is used. The major-surgery global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this service.

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 33425 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

33425 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$2,310.72
Alaska*Unavailable$3,217.44
ArizonaUnavailable$2,475.96
ArkansasUnavailable$2,281.94
AtlantaUnavailable$2,643.56
AustinUnavailable$2,537.72
BakersfieldUnavailable$2,474.30
Baltimore/Surr. CntysUnavailable$2,708.90
BeaumontUnavailable$2,474.38
BrazoriaUnavailable$2,470.03

33425 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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
33425 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 33425 rate is calculated

Each of 33425’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 · 33425

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 48.71Practice expense 15.64Malpractice 11.99

76.3400 adjusted RVUs×$33.4009 conversion factor=$2,549.82

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 33425

33425 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 33425

Mitral valve repair

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 · 33425

Mitral 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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

33425 without 51 · national facility

$2,549.82

Mitral valve repair

33425-51 · Second procedure: 50%

$1,274.91

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

33425 compared with similar codes

Compare codes

33425 vs 33426 vs 33430 vs 33418: national Medicare rates

Swap in your local Medicare rate.

  • 33425
    Mitral valve repair · 48.71 wRVU
    —
  • 33426
    Mitral valve repair · 42.2 wRVU
    —
  • 33430
    Mitral valve replacement · 49.66 wRVU
    —
  • 33418
    Mitral valve repair · 31.44 wRVU
    —

How to choose

33426Mitral valve repair
Both describe mitral valve repair with bypass. Choose 33425 when no prosthetic ring is used and 33426 when the repair includes a prosthetic ring.
33430Mitral valve replacement
33425 is for repair of the native mitral valve; 33430 is for replacement of the mitral valve.
33418Mitral valve repair
33425 describes open surgical repair with bypass. 33418 is a transcatheter mitral repair code.

Codes related to 33425

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

Codes related to 33425
CodeHow it relatesNational office range
Same family
33426Mitral valve repairMitral valve repair sibling for cases in which a prosthetic ring is used.No office rate
Used instead
33430Mitral valve replacementMitral valve replacement is selected when the valve is replaced rather than repaired.No office rate
33418Mitral valve repairTranscatheter mitral valve repair uses a catheter-based approach rather than open surgical repair.No office rate

33425 billing questions

How does this differ from 33426?

This code describes mitral valve repair without a prosthetic ring. Use 33426 when the operative report documents repair with a prosthetic ring.

Is cardiopulmonary bypass part of the coded service?

Yes. This code represents mitral valve repair performed with cardiopulmonary bypass, so the operative documentation should support its use.

Are the preoperative visit and postoperative care separately included?

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

Can an assistant surgeon or co-surgeon be reported?

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

Should modifier 50 be used?

No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.

How are other procedures in the same session paid?

Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.

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 33425PPRRVU2026_Oct_nonQPP.csv, line 3,952 (RVU26D)

Open CMS sourceHow we calculate rates

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