No office rate
Both short CMS labels refer broadly to heart-defect repair. Use the complete CPT descriptor and operative details to distinguish the defined procedures.
On this page
CMS RVU26D · Effective 2026-10-01
33720 Heart defect repair Medicare reimbursement rates in Arizona
Reports surgical repair of a heart defect when the operative service matches CPT 33720’s defined procedure and the record supports the work performed. Compare 33720 office and facility rates across CMS payment localities in Arizona.
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 33720 in Arizona?
Arizona has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1421.82
1 of 1 localities have a supported rate.
Payment area: Arizona
One mapped payment locality.
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.
Cardiac surgery
About 33720: Congenital heart defect repair
Reports surgical repair of a heart defect when the operative service matches CPT 33720’s defined procedure and the record supports the work performed.
CPT 33720 represents operative repair of a heart defect. The cardiothoracic surgeon corrects the structural abnormality during a surgical encounter; Medicare reported 2024 volume for this code was in the facility setting. The operative report should identify the defect and explain the repair performed, so the service can be matched to this code rather than another congenital heart repair code.
This major surgery has a 90-day global period, including 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 code. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 33720
- 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 RVU26.58 · 61%
- Practice expense (office) RVU10.59 · 24%
- Malpractice RVU6.69 · 15%
62
Medicare services in 2024 · #5221 by national volume
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.
33720 compared with similar codes
Office rates for Arizona, from the same CMS release.
No office rate
This is another separately defined heart-defect repair code. The specific defect and repair documented in the operative report determine which descriptor fits.
No office rate
33726 identifies repair of pulmonary venous stenosis. Choose it when that specific lesion and repair are documented, rather than relying on the broader short label for 33720.
Compare 33720 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.
1 of 1 payment localities
Arizona →
Office / nonfacility
Unavailable
Facility
$1421.82
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 33720 in Arizona.
PPRRVU2026_Oct_nonQPP.csv
4,040
- Code
- 33720
- Physician work
- 26.58
- Practice expense
- 10.59
- Malpractice
- 6.69
GPCI2026.csv
6
- Locality
- Arizona
- Physician work
- 1.000
- Practice expense
- 0.969
- Malpractice
- 0.856
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 26.58 | × 1.000 | 26.5800 |
| Practice expense | 10.59 | × 0.969 | 10.2617 |
| Malpractice | 6.69 | × 0.856 | 5.7266 |
| Total RVUs | 42.5684 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Arizona$1421.82
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 26.58 | 1 |
| Practice expense | 10.59 | 0.969 |
| Malpractice | 6.69 | 0.856 |
(26.58 × 1 + 10.59 × 0.969 + 6.69 × 0.856) × $33.4009 = $1421.82
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
33720 billing questions
How do I choose 33720 over 33702 or 33710?
Match the documented defect and operative technique to the complete CPT descriptor for each code. The short CMS label alone is not enough to distinguish these heart-defect repair codes.
What documentation supports reporting 33720?
The operative report should identify the heart defect and describe the repair performed. That detail supports code selection among separately defined congenital heart procedures.
Can related postoperative visits be billed separately?
Related postoperative care during the 90-day global period is included. The day-before preoperative visit is also included.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, while team surgery is not permitted.
Should modifier 50 be used for bilateral repair?
No. The descriptor and anatomy make modifier 50 inappropriate for 33720.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures performed in that session are subject to the standard multiple-procedure reduction.
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.
4,03733702,,Repair of heart defects,A,,26.56,10.58,NA,10.58,,6.68,43.82,43.82,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,0383370F,,Ajcc brst cncr stage 0 docd,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4,03933710,,Repair of heart defects,A,,36.56,11.33,NA,11.33,,9.22,57.11,57.11,0,090,0.09,0.84,0.07,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,04033720,,Repair of heart defect,A,,26.58,10.59,NA,10.59,,6.69,43.86,43.86,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,04133724,,Repair venous anomaly,A,,26.94,9.45,NA,9.45,,6.78,43.17,43.17,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,04233726,,Repair pul venous stenosis,A,,36.19,11.27,NA,11.27,,9.14,56.60,56.60,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,0433372F,,Ajcc brst cncr stage 1 docd,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515
801112,CA,54,BAKERSFIELD,1.019,1.096,0.609
901112,CA,55,CHICO,1.017,1.096,0.536