No office rate
Choose 33675 for closure of multiple VSDs without pulmonary artery band removal. 33677 captures the combined repair and removal.
On this page
CMS RVU26D · Effective 2026-10-01
33677 VSD repair Medicare reimbursement rates
Open repair closes multiple ventricular septal defects and removes a pulmonary artery band during the same operation, typically as staged congenital heart surgery. Compare 33677 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 33677?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 33677 pays more and less
Congenital cardiac surgery
About 33677: Multiple VSD closure with band removal
Open repair closes multiple ventricular septal defects and removes a pulmonary artery band during the same operation, typically as staged congenital heart surgery.
A congenital cardiac surgeon uses this code for an operation that closes multiple ventricular septal defects and removes a previously placed pulmonary artery band. This combination may occur in staged treatment of an infant or child whose band was used to control excessive pulmonary blood flow before definitive repair. The procedure is performed in a hospital operating room and may involve open-heart surgical techniques.
Report the code when the operative record supports both closure of multiple VSDs and removal of the band during the same operation. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one 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 made; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this service.
CMS billing rules for 33677
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU37.49 · 64%
- Practice expense (office) RVU11.53 · 20%
- Malpractice RVU9.44 · 16%
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.
33677 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
33676 is the multiple-VSD closure code associated with resection. Select 33677 when the documented combination is multiple VSD closure and pulmonary artery band removal.
No office rate
33688 combines band removal with closure of a single VSD; 33677 is for multiple VSDs closed during the operation.
No office rate
33681 is for closure of one VSD without the band-removal combination. It is not the choice when multiple VSDs are closed and the band is removed.
See how rates vary across the country
33677 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Compare 33677 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office Unavailable | Facility $1767.64 |
| Alaska* | Office Unavailable | Facility $2462.18 |
| Arizona | Office Unavailable | Facility $1895.27 |
| Arkansas | Office Unavailable | Facility $1745.39 |
| Atlanta | Office Unavailable | Facility $2025.91 |
| Austin | Office Unavailable | Facility $1941.51 |
| Bakersfield | Office Unavailable | Facility $1890.10 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $2075.49 |
| Beaumont | Office Unavailable | Facility $1895.57 |
| Brazoria | Office Unavailable | Facility $1889.80 |
| Chicago | Office Unavailable | Facility $2371.63 |
| Chico | Office Unavailable | Facility $1864.57 |
| Colorado | Office Unavailable | Facility $1923.24 |
| Connecticut | Office Unavailable | Facility $2073.53 |
| Dallas | Office Unavailable | Facility $1917.57 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $2124.41 |
| Delaware | Office Unavailable | Facility $1922.41 |
| Detroit | Office Unavailable | Facility $2155.44 |
| East St. Louis | Office Unavailable | Facility $2241.53 |
| El Centro | Office Unavailable | Facility $1866.15 |
| Fort Lauderdale | Office Unavailable | Facility $2212.39 |
| Fort Worth | Office Unavailable | Facility $1917.82 |
| Fresno | Office Unavailable | Facility $1864.57 |
| Galveston | Office Unavailable | Facility $1905.71 |
| Hanford-Corcoran | Office Unavailable | Facility $1864.57 |
| Hawaii, Guam | Office Unavailable | Facility $1872.63 |
| Houston | Office Unavailable | Facility $2078.49 |
| Idaho | Office Unavailable | Facility $1755.64 |
| Indiana | Office Unavailable | Facility $1762.44 |
| Iowa | Office Unavailable | Facility $1729.75 |
| Kansas | Office Unavailable | Facility $1759.25 |
| Kentucky | Office Unavailable | Facility $1883.07 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $1968.49 |
| Madera | Office Unavailable | Facility $1864.57 |
| Manhattan | Office Unavailable | Facility $2279.91 |
| Merced | Office Unavailable | Facility $1864.57 |
| Metropolitan Boston | Office Unavailable | Facility $2043.99 |
| Metropolitan Kansas City | Office Unavailable | Facility $1921.87 |
| Metropolitan Philadelphia | Office Unavailable | Facility $2051.80 |
| Metropolitan St. Louis | Office Unavailable | Facility $1934.76 |
| Miami | Office Unavailable | Facility $2450.51 |
| Minnesota | Office Unavailable | Facility $1741.81 |
| Mississippi | Office Unavailable | Facility $1816.79 |
| Modesto | Office Unavailable | Facility $1864.57 |
| Montana** | Office Unavailable | Facility $1951.99 |
| Napa | Office Unavailable | Facility $1998.84 |
| Nebraska | Office Unavailable | Facility $1726.84 |
| Nevada** | Office Unavailable | Facility $1900.35 |
| New Hampshire | Office Unavailable | Facility $1928.99 |
| New Mexico | Office Unavailable | Facility $1984.03 |
| New Orleans | Office Unavailable | Facility $1972.78 |
| North Carolina | Office Unavailable | Facility $1812.99 |
| North Dakota** | Office Unavailable | Facility $1765.33 |
| Northern Nj | Office Unavailable | Facility $2114.56 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $2375.76 |
| Ohio | Office Unavailable | Facility $1921.63 |
| Oklahoma | Office Unavailable | Facility $1841.10 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $1938.90 |
| Portland | Office Unavailable | Facility $1934.68 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $2111.77 |
| Puerto Rico | Office Unavailable | Facility $1952.12 |
| Queens | Office Unavailable | Facility $2242.21 |
| Redding | Office Unavailable | Facility $1864.57 |
| Rest Of California | Office Unavailable | Facility $1864.57 |
| Rest Of Florida | Office Unavailable | Facility $2094.27 |
| Rest Of Georgia | Office Unavailable | Facility $1971.56 |
| Rest Of Illinois | Office Unavailable | Facility $2096.63 |
| Rest Of Louisiana | Office Unavailable | Facility $1895.09 |
| Rest Of Maine | Office Unavailable | Facility $1802.62 |
| Rest Of Maryland | Office Unavailable | Facility $1943.90 |
| Rest Of Massachusetts | Office Unavailable | Facility $1929.06 |
| Rest Of Michigan | Office Unavailable | Facility $1959.79 |
| Rest Of Missouri | Office Unavailable | Facility $1891.27 |
| Rest Of New Jersey | Office Unavailable | Facility $2068.72 |
| Rest Of New York | Office Unavailable | Facility $1839.72 |
| Rest Of Oregon | Office Unavailable | Facility $1857.43 |
| Rest Of Pennsylvania | Office Unavailable | Facility $1903.70 |
| Rest Of Texas | Office Unavailable | Facility $1902.39 |
| Rest Of Washington | Office Unavailable | Facility $1913.95 |
| Rhode Island | Office Unavailable | Facility $1955.06 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $1965.78 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $1914.17 |
| Salinas | Office Unavailable | Facility $1906.37 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $1921.26 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $2058.89 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $2048.17 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $2114.28 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $2070.45 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $1881.13 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $1915.41 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $1905.31 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $1931.69 |
| Seattle (King Cnty) | Office Unavailable | Facility $2044.95 |
| South Carolina | Office Unavailable | Facility $1876.05 |
| South Dakota** | Office Unavailable | Facility $1743.25 |
| Southern Maine | Office Unavailable | Facility $1832.80 |
| Stockton | Office Unavailable | Facility $1864.57 |
| Suburban Chicago | Office Unavailable | Facility $2215.20 |
| Tennessee | Office Unavailable | Facility $1771.59 |
| Utah | Office Unavailable | Facility $1897.35 |
| Vallejo | Office Unavailable | Facility $1983.39 |
| Vermont | Office Unavailable | Facility $1793.01 |
| Virgin Islands | Office Unavailable | Facility $1952.12 |
| Virginia | Office Unavailable | Facility $1853.37 |
| Visalia | Office Unavailable | Facility $1864.57 |
| West Virginia | Office Unavailable | Facility $2038.06 |
| Wisconsin | Office Unavailable | Facility $1718.25 |
| Wyoming** | Office Unavailable | Facility $1870.64 |
| Yuba City | Office Unavailable | Facility $1864.57 |
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33677 billing questions
How does this differ from 33675?
33677 includes removal of a pulmonary artery band along with closure of multiple VSDs. 33675 describes closure of multiple VSDs without that band-removal element.
Is removal of the pulmonary artery band separately reported?
Band removal is part of the service represented by 33677 when performed with closure of the multiple VSDs. Do not separately report that same removal as a stand-alone service for the combined operation.
When is 33688 a closer choice?
33688 describes closure of a single VSD with removal of a pulmonary artery band. Use 33677 when multiple VSDs are closed and the band is removed.
Can 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 performed in that session are paid at 50%.
What supports reporting 33677?
The operative report should establish that multiple VSDs were closed and a previously placed pulmonary artery band was removed in the same operation.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
4,02633670,,Repair of heart chambers,A,,35.71,9.74,NA,9.74,,9.00,54.45,54.45,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,02733675,,Close mult vsd,A,,35.05,11.06,NA,11.06,,8.84,54.95,54.95,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,02833676,,Close mult vsd w/resection,A,,36.03,11.24,NA,11.24,,9.09,56.36,56.36,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,02933677,,Cl mult vsd w/rem pul band,A,,37.49,11.53,NA,11.53,,9.44,58.46,58.46,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,03033681,,Closure 1 vsd w/wo patch,A,,31.53,12.79,NA,12.79,,7.95,52.27,52.27,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,03133684,,Clsr 1 vsd w/wo patch w/vlvt,A,,33.51,10.73,NA,10.73,,8.46,52.70,52.70,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,03233688,,Clsr 1vsd w/wo ptch rmvl bnd,A,,33.88,9.74,NA,9.74,,8.55,52.17,52.17,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00