Billing code 33474: Pulmonary valve surgeryMedicare rate & RVUs in Illinois
Report surgical revision of the pulmonary valve to correct valve dysfunction when the surgeon repairs the valve rather than replacing it.
CMS doesn’t publish an office rate for 33474 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 33474 covers
A cardiothoracic surgeon uses this code for an operation that revises the pulmonary valve, such as correcting valve narrowing or leakage while retaining the valve. These procedures are performed in a cardiac surgery setting, often for congenital or acquired pulmonary valve disease. The operative report should identify the pulmonary valve abnormality and describe the repair performed.
Choose this code when the surgeon revises the pulmonary valve; use a replacement code when the valve is removed and replaced. The note should distinguish valve work from any separate work on a heart chamber or another valve. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard reduction. Modifier 50 is inappropriate for this anatomy. Assistant-at-surgery payment may be allowed; 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 33474 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 | $2,468.92 |
| East St. Louis | Unavailable | $2,332.24 |
| Rest Of Illinois | Unavailable | $2,182.95 |
| Suburban Chicago | Unavailable | $2,308.76 |
How the 33474 rate is calculated
Each of 33474’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 · 33474
RVUs × geographic indexes × conversion factor
Work38.42
38.42 RVUs× 1.000 GPCI
Practice expense12.88
12.88 RVUs× 1.000 GPCI
Malpractice9.71
9.71 RVUs× 1.000 GPCI
Adjusted RVUs
61.0100
Conversion factor
$33.4009
Medicare rate
$2,037.79
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33474
33474 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33474
Pulmonary valve surgery
| 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 · 33474
Pulmonary valve surgery
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
33474 without 51 · national facility
$2,037.79
Pulmonary valve surgery
33474-51 · Second procedure: 50%
$1,018.90
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%).
33474 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 33475Pulmonary valve replacement
- 33474 is for surgical revision of the pulmonary valve; 33475 is for replacement of the valve.
- 33477Pulmonary valve implant
- 33474 describes surgical revision. 33477 describes transcatheter implantation of a pulmonary valve.
- 33476Ventriculoplasty
- 33474 addresses the pulmonary valve itself. 33476 is for revision of a heart chamber, not valve revision.
33474 billing questions
How does 33474 differ from pulmonary valve replacement?
Use 33474 when the surgeon revises the pulmonary valve without replacing it. When the valve is removed and replaced, consider 33475.
How does surgical revision differ from transcatheter pulmonary valve implantation?
33474 describes surgical valve revision. Code 33477 is for transcatheter pulmonary valve implantation, a different approach.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this code because of the descriptor or anatomy.
What documentation supports reporting 33474?
The operative report should identify the pulmonary valve condition and describe the revision, making clear whether the surgeon repaired the valve or replaced it.
How are other procedures in the same session paid?
Under the standard multiple-procedure rule, the highest-valued procedure is paid in full and other procedures are subject to the reduction. Related postoperative care falls within the 90-day global period.
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.
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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