Billing code 33430: Mitral valve replacementMedicare rate & RVUs in Illinois
Report open surgical replacement when the diseased mitral valve is removed and a prosthetic valve is implanted rather than repaired.
CMS doesn’t publish an office rate for 33430 in Illinois.
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 33430 covers
This service replaces the mitral valve during open cardiac surgery, typically using cardiopulmonary bypass. The surgeon removes the diseased valve and implants a prosthetic valve; the operation is generally performed in a hospital operating room by a cardiac surgeon. The operative report should establish that replacement, rather than repair or revision, was performed and identify the valve treated and the implanted prosthesis.
Select this code for mitral valve replacement, not for a procedure that preserves and repairs the native valve. Report other procedures performed in the same session when separately supported; under the standard multiple-procedure rule, the highest-valued procedure is paid in full and the others at 50%. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. An assistant at surgery may be paid. 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 33430 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $3,167.22 |
| East St. Louis | Unavailable | $2,993.45 |
| Rest Of Illinois | Unavailable | $2,805.03 |
| Suburban Chicago | Unavailable | $2,965.44 |
How the 33430 rate is calculated
Each of 33430’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 · 33430
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 49.66Practice expense 16.62Malpractice 12.25
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 33430
33430 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33430
Mitral valve replacement
| 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 · 33430
Mitral valve replacement
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
33430 without 51 · national facility
$2,622.97
Mitral valve replacement
33430-51 · Second procedure: 50%
$1,311.49
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%).
33430 compared with similar codes
Compare codes
33430 vs 33425 vs 33427 vs 33418 vs 33405: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 33425Mitral valve repair
- 33430 replaces the mitral valve with a prosthesis. 33425 is for mitral valve repair with bypass when the surgeon preserves the native valve.
- 33427Mitral valve repair
- Choose 33430 for valve replacement. 33427 describes mitral valve reconstruction, not implantation of a replacement valve.
- 33418Mitral valve repair
- 33430 is open surgical replacement. 33418 describes catheter-based mitral valve repair rather than open replacement.
- 33405Aortic valve replacement
- 33405 concerns replacement of the aortic valve; 33430 is specific to replacement of the mitral valve.
33430 billing questions
How is replacement distinguished from mitral valve repair?
Use 33430 when the surgeon replaces the mitral valve with a prosthesis. Codes such as 33425–33427 describe mitral valve repair procedures that preserve the native valve.
What operative documentation supports 33430?
The operative report should document replacement of the mitral valve, rather than repair or revision, and identify the implanted prosthesis and any other procedures performed.
How are other procedures in the same session paid?
When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the other procedures are subject to the standard 50% multiple-procedure reduction.
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 90-day 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
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