No office rate
Both describe open mitral repair on bypass. Choose 33426 when a prosthetic ring is used; choose 33425 when the repair is performed without one.
On this page
CMS RVU26D · Effective 2026-10-01
33426 Mitral valve repair Medicare reimbursement rates in Indiana
Open mitral valve repair with a prosthetic annuloplasty ring on cardiopulmonary bypass, reported when the native valve is repaired rather than replaced. Compare 33426 office and facility rates across CMS payment localities in Indiana.
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 33426 in Indiana?
Indiana 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
$2018.19
1 of 1 localities have a supported rate.
Payment area: Indiana
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 33426: Mitral valve repair with annuloplasty ring
Open mitral valve repair with a prosthetic annuloplasty ring on cardiopulmonary bypass, reported when the native valve is repaired rather than replaced.
A cardiac surgeon uses this service for open repair of the native mitral valve on cardiopulmonary bypass, placing a prosthetic ring to reshape or support the valve annulus. It is used for conditions such as mitral regurgitation when the surgeon repairs the valve rather than replacing it. The operation is generally performed in a hospital operating room; the ring placement is part of the repair service.
Select this code when the operative report documents mitral valve repair with a prosthetic ring. Repair without a ring is coded differently, and extensive reconstruction has a separate code. The service has a 90-day global period that includes the day-before preoperative visit and related postoperative care for 90 days. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures receive the standard multiple-procedure reduction. Modifier 50 is inappropriate for this single-valve service. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation. CMS does not permit team-surgery payment for this code.
CMS billing rules for 33426
- 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 RVU42.20 · 63%
- Practice expense (office) RVU14.19 · 21%
- Malpractice RVU10.43 · 16%
2.9K
Medicare services in 2024 · #2210 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.
33426 compared with similar codes
Office rates for Indiana, from the same CMS release.
No office rate
This code identifies repair with a prosthetic ring. Code 33427 is for extensive reconstruction, based on the operative technique documented.
No office rate
33426 preserves and repairs the native mitral valve with a ring. Use 33430 when the operation replaces the valve instead.
No office rate
33418 is a catheter-based mitral repair approach. This code is for open repair on cardiopulmonary bypass with a prosthetic ring.
Compare 33426 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
Indiana →
Office / nonfacility
Unavailable
Facility
$2018.19
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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 33426 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
3,953
- Code
- 33426
- Physician work
- 42.20
- Practice expense
- 14.19
- Malpractice
- 10.43
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 42.20 | × 1.000 | 42.2000 |
| Practice expense | 14.19 | × 0.927 | 13.1541 |
| Malpractice | 10.43 | × 0.486 | 5.0690 |
| Total RVUs | 60.4231 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Indiana$2018.19
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 42.2 | 1 |
| Practice expense | 14.19 | 0.927 |
| Malpractice | 10.43 | 0.486 |
(42.2 × 1 + 14.19 × 0.927 + 10.43 × 0.486) × $33.4009 = $2018.19
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.
33426 billing questions
How is this code distinguished from 33425?
Use this code when the mitral repair includes a prosthetic annuloplasty ring. Code 33425 describes the related repair without a ring.
Is cardiopulmonary bypass separately reported?
The repair service is performed on cardiopulmonary bypass; bypass is part of this operative service, not a separate unit of mitral repair.
Can an assistant surgeon or co-surgeon be reported?
CMS permits assistant-at-surgery payment for this code. Co-surgeon payment requires supporting documentation, and team-surgery payment is unavailable.
What does the 90-day global period include?
It includes the day-before preoperative visit and 90 days of related postoperative care. The global period is tied to the repair operation.
Should modifier 50 or separate right- and left-sided units be used?
No. This is a single mitral-valve operation, not a bilateral procedure; modifier 50 and separate side-based units are inappropriate.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures in the same 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.
3,95033420,,Revision of mitral valve,A,,25.15,10.36,NA,10.36,,6.02,41.53,41.53,0,090,0.09,0.84,0.07,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,95133422,,Revision of mitral valve,A,,28.99,11.60,NA,11.60,,6.96,47.55,47.55,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,95233425,,Repair of mitral valve,A,,48.71,15.64,NA,15.64,,11.99,76.34,76.34,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,95333426,,Repair of mitral valve,A,,42.20,14.19,NA,14.19,,10.43,66.82,66.82,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,95433427,,Repair of mitral valve,A,,43.71,13.84,NA,13.84,,10.51,68.06,68.06,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,9553342F,,Mammo assess bengn 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
3,95633430,,Replacement of mitral valve,A,,49.66,16.62,NA,16.62,,12.25,78.53,78.53,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915