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Billing code 33477: Pulmonary valve implantMedicare rate & RVUs

Reports catheter-delivered implantation of a prosthetic pulmonary valve, commonly for a dysfunctional valve or right ventricular outflow tract conduit.

CMS RVU26DEffective Oct 1, 2026109 payment localities160 Medicare services in 2024

Medicare pays $1,126.28 for 33477 nationally in a facility.

Medicare rate · 33477

Pulmonary valve implant

Swap in your local Medicare rate.

Work RVUs
24.38
Total RVUs
33.72
Global days
000

National rate · 2026

$1,126.28

Facility setting, before claim adjustments.

See every locality for 33477 → · 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 33477 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 33477 covers

This service places a prosthetic pulmonary valve through a catheter rather than by open valve surgery. It is commonly performed by interventional cardiologists with congenital heart or cardiothoracic teams in a catheterization laboratory or hybrid procedural setting. Typical cases involve pulmonary valve dysfunction in a patient with congenital heart disease, including failure of a prior right ventricular outflow tract conduit or pulmonary valve prosthesis.

Report the code when the documented procedure includes transcatheter implantation of the pulmonary valve prosthesis. The operative report should identify the valve and access approach and describe prosthesis deployment. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires medical-necessity documentation; co-surgeon and team-surgery payment require supporting documentation.

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 33477 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

33477 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,043.63
Alaska*Unavailable$1,481.09
ArizonaUnavailable$1,100.64
ArkansasUnavailable$1,033.69
AtlantaUnavailable$1,159.85
AustinUnavailable$1,121.70
BakersfieldUnavailable$1,102.89
Baltimore/Surr. CntysUnavailable$1,185.25
BeaumontUnavailable$1,100.89
BrazoriaUnavailable$1,100.17

33477 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
33477 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 33477 rate is calculated

Each of 33477’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 · 33477

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 24.38Practice expense 5.11Malpractice 4.23

33.7200 adjusted RVUs×$33.4009 conversion factor=$1,126.28

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

Payment rules and modifiers for 33477

The CMS indicators that decide how 33477 is paid alongside other services.

CMS payment indicators · 33477

Pulmonary valve implant

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is 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)0Not paid without supporting documentation.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)1Permitted with supporting documentation.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

33477 without 51 · national facility

$1,126.28

Pulmonary valve implant

33477-51 · Second procedure: 50%

$563.14

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

33477 compared with similar codes

Compare codes

33477 vs 33475 vs 33474 vs 33418: national Medicare rates

Swap in your local Medicare rate.

  • 33477
    Pulmonary valve implant · 24.38 wRVU
    —
  • 33475
    Pulmonary valve replacement · 41.34 wRVU
    —
  • 33474
    Pulmonary valve surgery · 38.42 wRVU
    —
  • 33418
    Mitral valve repair · 31.44 wRVU
    —

How to choose

33475Pulmonary valve replacement
Use 33477 for catheter-delivered pulmonary valve implantation; 33475 describes pulmonary valve replacement by an open surgical approach.
33474Pulmonary valve surgery
Code 33474 describes pulmonary valve revision, while 33477 reports transcatheter implantation of a prosthetic pulmonary valve.
33418Mitral valve repair
Both involve a transcatheter valve procedure, but 33418 addresses mitral valve repair; 33477 is for pulmonary valve implantation.

Codes related to 33477

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

Codes related to 33477
CodeHow it relatesNational office range
Used instead
33475Pulmonary valve replacementPulmonary valve replacement by an open surgical approach rather than transcatheter implantation.No office rate
33474Pulmonary valve surgeryPulmonary valve revision rather than catheter-delivered prosthetic valve implantation.No office rate

33477 billing questions

How does this differ from open pulmonary valve replacement?

This code is for catheter-delivered implantation. Code 33475 describes pulmonary valve replacement by an open surgical approach.

Can modifier 50 be used?

No. CMS identifies bilateral adjustment as inappropriate because of the descriptor or anatomy.

What same-day care is included in the global period?

The 0-day global period includes same-day preoperative and postoperative care.

How are other procedures in the same session paid?

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

What documentation supports assistant or team-surgery payment?

Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeon and team-surgery payment require supporting documentation.

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 33477PPRRVU2026_Oct_nonQPP.csv, line 3,969 (RVU26D)

Open CMS sourceHow we calculate rates

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