No office rate
Both describe closure of one VSD, with or without a patch. Choose 33684 when pulmonary valvotomy is also performed as part of the repair.
On this page
CMS RVU26D · Effective 2026-10-01
33684 VSD closure Medicare reimbursement rates in Idaho
Reports surgical closure of one ventricular septal defect together with pulmonary valve incision to relieve obstruction during congenital heart repair. Compare 33684 office and facility rates across CMS payment localities in Idaho.
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 33684 in Idaho?
Idaho 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
$1582.64
1 of 1 localities have a supported rate.
Payment area: Idaho
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.
Congenital cardiac surgery
About 33684: Single VSD closure with pulmonary valvotomy
Reports surgical closure of one ventricular septal defect together with pulmonary valve incision to relieve obstruction during congenital heart repair.
This code describes open repair of a single ventricular septal defect (VSD) performed with pulmonary valvotomy. The surgeon closes the opening between the ventricles, using direct sutures or a patch as the anatomy requires, and incises the pulmonary valve to improve its opening. It is used for congenital cardiac operations in which both services are part of the same repair, commonly performed by a congenital cardiac surgeon in a hospital operating room.
Report the code when the operative documentation supports closure of one VSD and the accompanying pulmonary valvotomy. The record should identify the defect and describe the valve work; whether the septal closure uses a patch does not change the code selection. Medicare assigns 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 multiple procedure reduction. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 33684
- 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 RVU33.51 · 64%
- Practice expense (office) RVU10.73 · 20%
- Malpractice RVU8.46 · 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.
33684 compared with similar codes
Office rates for Idaho, from the same CMS release.
No office rate
33675 is for closure of multiple VSDs. This code is for a single VSD and includes pulmonary valvotomy.
No office rate
33688 describes single-VSD closure with removal of a pulmonary artery band. This code is distinguished by pulmonary valvotomy.
Compare 33684 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
Idaho →
Office / nonfacility
Unavailable
Facility
$1582.64
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 33684 in Idaho.
PPRRVU2026_Oct_nonQPP.csv
4,031
- Code
- 33684
- Physician work
- 33.51
- Practice expense
- 10.73
- Malpractice
- 8.46
GPCI2026.csv
47
- Locality
- Idaho
- Physician work
- 1.000
- Practice expense
- 0.920
- Malpractice
- 0.473
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 33.51 | × 1.000 | 33.5100 |
| Practice expense | 10.73 | × 0.920 | 9.8716 |
| Malpractice | 8.46 | × 0.473 | 4.0016 |
| Total RVUs | 47.3832 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Idaho$1582.64
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 33.51 | 1 |
| Practice expense | 10.73 | 0.92 |
| Malpractice | 8.46 | 0.473 |
(33.51 × 1 + 10.73 × 0.92 + 8.46 × 0.473) × $33.4009 = $1582.64
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.
33684 billing questions
How does this differ from 33681?
33684 includes pulmonary valvotomy with closure of one VSD. Use 33681 for the single-VSD closure when pulmonary valvotomy is not part of the repair.
Does the code require a patch?
No. The VSD may be closed with direct sutures or a patch; the defining distinction is the accompanying pulmonary valvotomy.
Can this code be used for multiple VSDs?
No. This code describes closure of one VSD. Codes such as 33675 and 33676 address multiple-defect repairs, with 33676 also specifying resection.
What documentation supports reporting 33684?
The operative report should establish that one VSD was closed and that pulmonary valvotomy was performed during the repair. It should describe the closure method and the valve work.
How is same-session surgery paid under Medicare?
When multiple procedures are performed in the same session, Medicare pays the highest-valued procedure in full and applies the standard multiple procedure reduction to the others. The 90-day global period includes the day-before preoperative visit and related postoperative care.
May an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
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.
4,02833676,,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
4,03333690,,Banding pulmonary artery,A,,19.85,9.76,NA,9.76,,4.99,34.60,34.60,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,03433692,,Comp rpr tof wo pulm atresia,A,,35.25,10.01,NA,10.01,,8.90,54.16,54.16,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772