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Billing code 33545: Heart repairMedicare rate & RVUs

Reports surgical repair of a ventricular septal defect caused by myocardial infarction, with or without removal of damaged heart muscle.

CMS RVU26DEffective Oct 1, 2026109 payment localities45 Medicare services in 2024

Medicare pays $2,868.14 for 33545 nationally in a facility.

Medicare rate · 33545

Heart repair

Swap in your local Medicare rate.

Work RVUs
55.63
Total RVUs
85.87
Global days
090

National rate · 2026

$2,868.14

Facility setting, before claim adjustments.

See every locality for 33545 → · 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 33545 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 33545 covers

A cardiothoracic surgeon uses this code to repair a ventricular septal defect that developed as a complication of myocardial infarction. The operation may include removing infarcted myocardium as part of the repair. It is a major open-heart service generally performed in a hospital operating room, often when the defect causes significant shunting or hemodynamic instability. The operative report should identify the defect as postinfarction and describe the repair and any myocardial resection.

Report the code for the postinfarction defect repair, not for repair of a congenital septal defect or treatment of a ventricular aneurysm. The 90-day global period 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 50% multiple-procedure reduction. Modifier 50 is inappropriate for this service. Assistant-at-surgery payment may be available; 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 33545 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

33545 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$2,603.99
Alaska*Unavailable$3,633.47
ArizonaUnavailable$2,786.40
ArkansasUnavailable$2,572.21
AtlantaUnavailable$2,972.42
AustinUnavailable$2,853.68
BakersfieldUnavailable$2,783.09
Baltimore/Surr. CntysUnavailable$3,044.78
BeaumontUnavailable$2,785.71
BrazoriaUnavailable$2,779.75

33545 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
33545 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 33545 rate is calculated

Each of 33545’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 · 33545

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 55.63Practice expense 16.88Malpractice 13.36

85.8700 adjusted RVUs×$33.4009 conversion factor=$2,868.14

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

Payment rules and modifiers for 33545

33545 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 33545

Heart 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 · 33545

Heart 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

33545 without 51 · national facility

$2,868.14

Heart repair

33545-51 · Second procedure: 50%

$1,434.07

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

33545 compared with similar codes

Compare codes

33545 vs 33542 vs 33548 vs 33510: national Medicare rates

Swap in your local Medicare rate.

  • 33545
    Heart repair · 55.63 wRVU
    —
  • 33542
    Heart lesion removal · 47 wRVU
    —
  • 33548
    Ventricular restoration · 52.79 wRVU
    —
  • 33510
    Coronary bypass · 34.11 wRVU
    —

How to choose

33542Heart lesion removal
Use 33542 for excision of a ventricular aneurysm. Use 33545 for repair of a ventricular septal defect caused by myocardial infarction.
33548Ventricular restoration
Use 33548 for a surgical ventricular restoration or remodeling procedure. It does not describe repair of a postinfarction ventricular septal defect.
33510Coronary bypass
33510 reports a single venous coronary bypass graft, not repair of a postinfarction septal defect. Both may be reported when both services are performed in the same operation.

Codes related to 33545

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

Codes related to 33545
CodeHow it relatesNational office range
Often billed with
33510Coronary bypassA single venous coronary bypass graft may be performed during the same operation when indicated.No office rate
33533Arterial CABGA single arterial coronary bypass graft may be performed during the same operation when indicated.No office rate
33542Heart lesion removalMay be reported when ventricular aneurysm excision is also performed as a distinct service.No office rate

33545 billing questions

How is this different from ventricular aneurysm surgery?

This code is for repair of a ventricular septal defect caused by myocardial infarction. Ventricular aneurysm excision or ventricular restoration addresses a different postinfarction heart problem.

Can CABG be reported during the same operation?

Yes, when coronary bypass grafting is separately performed, report the applicable CABG code based on the graft type and count. Same-session procedures are subject to the multiple-procedure payment rule.

What documentation supports this code?

The operative report should establish that the septal defect followed a myocardial infarction and describe its surgical repair. Document any myocardial resection performed as part of the operation.

Can modifier 50 be used?

No. The descriptor and anatomy make bilateral reporting with modifier 50 inappropriate.

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 major-surgery 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 33545PPRRVU2026_Oct_nonQPP.csv, line 4,004 (RVU26D)

Open CMS sourceHow we calculate rates

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