Billing code 33920: Congenital heart repairMedicare rate & RVUs in Florida
Reports surgical repair of pulmonary atresia with a ventricular septal defect, including cases with hypoplastic pulmonary arteries.
CMS doesn’t publish an office rate for 33920 in Florida.
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 9 sections
What 33920 covers
This operation treats pulmonary atresia with a ventricular septal defect, a congenital defect in which the normal route from the right ventricle to the pulmonary arteries is absent. A congenital cardiac surgeon reconstructs pulmonary blood flow and addresses the septal defect; repair may include an RV-to-pulmonary artery conduit. It is performed in an operating room, typically in a hospital, for patients requiring definitive correction of this complex heart defect.
Select the code when the operation repairs pulmonary atresia with the associated VSD, whether or not the pulmonary arteries are hypoplastic. The operative report should establish the congenital anatomy and describe the repair performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard reduction. Modifier 50 is inappropriate. 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 33920 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | Unavailable | $1,911.95 |
| Miami | Unavailable | $2,115.76 |
| Rest Of Florida | Unavailable | $1,809.71 |
How the 33920 rate is calculated
Each of 33920’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 · 33920
RVUs × geographic indexes × conversion factor
Work31.92
31.92 RVUs× 1.000 GPCI
Practice expense10.63
10.63 RVUs× 1.000 GPCI
Malpractice8.05
8.05 RVUs× 1.000 GPCI
Adjusted RVUs
50.6000
Conversion factor
$33.4009
Medicare rate
$1,690.09
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33920
33920 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33920
Congenital heart repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.84/0.07 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 33920
Congenital 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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
33920 without 51 · national facility
$1,690.09
Congenital heart repair
33920-51 · Second procedure: 50%
$845.05
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%).
33920 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 33925Pulmonary artery repair
- This code describes pulmonary artery unifocalization without cardiopulmonary bypass for pulmonary atresia with VSD. Choose 33920 for the repair represented by the atresia-with-VSD code rather than unifocalization alone.
- 33926Pulmonary artery repair
- This code describes pulmonary artery unifocalization with cardiopulmonary bypass. The bypass distinction separates it from 33925; 33920 represents repair of pulmonary atresia with VSD.
- 33917Pulmonary artery repair
- 33917 is for repair of a pulmonary artery. Use 33920 when the operation is repair of pulmonary atresia with the associated VSD, not an isolated pulmonary artery repair.
33920 billing questions
When is this code appropriate instead of 33925 or 33926?
Use 33920 for repair of pulmonary atresia with a VSD. Codes 33925 and 33926 describe pulmonary artery unifocalization without or with cardiopulmonary bypass, respectively.
Does pulmonary artery hypoplasia change code selection?
No. The repair represented by 33920 includes cases with or without pulmonary artery hypoplasia.
Should modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for this code.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
What documentation supports reporting 33920?
Document pulmonary atresia with the VSD and the operative work performed to repair the congenital anatomy. Include the relevant pulmonary artery anatomy, such as hypoplasia when present.
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
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