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Billing code 33465: Valve replacementMedicare rate & RVUs

Reports open surgical replacement of a diseased tricuspid valve, typically during cardiopulmonary bypass when repair is not the operative treatment.

CMS RVU26DEffective Oct 1, 2026109 payment localities576 Medicare services in 2024

Medicare pays $2,563.85 for 33465 nationally in a facility.

Medicare rate · 33465

Valve replacement

Work RVUs
49.45
Total RVUs
76.76
Global days
090

National rate · 2026

$2,563.85

Facility setting, before claim adjustments.

See every locality for 33465 →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 33465 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 33465 covers

A cardiothoracic surgeon removes the diseased tricuspid valve and replaces it with a prosthetic valve during open heart surgery with cardiopulmonary bypass. The operation may be performed for severe tricuspid valve disease, including stenosis or regurgitation, when the surgeon replaces rather than reconstructs the native valve. It is generally performed in a hospital operating room by a cardiac surgery team.

Report this code when the operative documentation supports tricuspid valve replacement, not a repair that preserves the native valve. The record should identify the valve treated and the replacement performed. 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 others at 50%. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted. Modifier 50 is not appropriate for this single tricuspid valve operation.

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 33465 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

33465 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$2,324.95
Alaska*Unavailable$3,241.25
ArizonaUnavailable$2,489.91
ArkansasUnavailable$2,296.21
AtlantaUnavailable$2,658.17
AustinUnavailable$2,550.55
BakersfieldUnavailable$2,485.98
Baltimore/Surr. CntysUnavailable$2,723.15
BeaumontUnavailable$2,489.44
BrazoriaUnavailable$2,483.58

33465 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
33465 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 33465 rate is calculated

Each of 33465’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 · 33465

RVUs × geographic indexes × conversion factor

Work49.45

49.45 RVUs× 1.000 GPCI

Practice expense15.21

15.21 RVUs× 1.000 GPCI

Malpractice12.10

12.10 RVUs× 1.000 GPCI

Adjusted RVUs

76.7600

Conversion factor

$33.4009

Medicare rate

$2,563.85

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

Payment rules and modifiers for 33465

33465 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 33465

Valve 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 · 33465

Valve 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

33465 without 51 · national facility

$2,563.85

Valve replacement

33465-51 · Second procedure: 50%

$1,281.93

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

33465 compared with similar codes

Compare codes · National

5 codes, side by side

  • 33465

    Valve replacement49.45 wRVU

    Not priced

  • 33463

    Tricuspid repair55.65 wRVU

    Not priced

  • 33464

    Tricuspid repair43.5 wRVU

    Not priced

  • 33468

    Tricuspid valve surgery44 wRVU

    Not priced

  • 33430

    Mitral valve replacement49.66 wRVU

    Not priced

How to choose

33463Tricuspid repair
Choose 33463 for tricuspid repair with ring insertion; choose 33465 when the surgeon replaces the valve.
33464Tricuspid repair
Choose 33464 for tricuspid repair without ring insertion. Replacement of the tricuspid valve is reported with 33465.
33468Tricuspid valve surgery
33468 describes repair for Ebstein anomaly; 33465 is for replacement of the tricuspid valve.
33430Mitral valve replacement
33430 is replacement of the mitral valve. Use 33465 when the valve replaced is the tricuspid valve.

Codes related to 33465

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

Codes related to 33465
CodeHow it relatesNational office range
Used instead
33463Tricuspid repairTricuspid valve repair with ring insertion when the native valve is retained.No office rate
33464Tricuspid repairTricuspid valve repair without ring insertion when the native valve is retained.No office rate
33468Tricuspid valve surgeryTricuspid valve repair for Ebstein anomaly rather than valve replacement.No office rate

33465 billing questions

How is replacement distinguished from tricuspid valvuloplasty?

Use 33465 when the surgeon replaces the tricuspid valve. Codes 33463 and 33464 describe repair procedures that retain the native valve.

Does this code include the related postoperative visits?

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

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

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%.

What documentation supports reporting 33465?

The operative report should identify the tricuspid valve and document that it was replaced, rather than repaired with the native valve retained.

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 33465PPRRVU2026_Oct_nonQPP.csv, line 3,964 (RVU26D)

Open CMS sourceHow we calculate rates

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