No office rate
Both describe closure of one VSD, but 33688 includes removal of a pulmonary artery band. Choose 33681 when that band-removal service is not part of the operation.
On this page
CMS RVU26D · Effective 2026-10-01
33688 VSD closure Medicare reimbursement rates in Indiana
Reports surgical closure of one ventricular septal defect together with removal of a previously placed pulmonary artery band. Compare 33688 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 33688 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
$1571.99
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.
Congenital cardiac surgery
About 33688: Single VSD closure with band removal
Reports surgical closure of one ventricular septal defect together with removal of a previously placed pulmonary artery band.
This code describes an operation that closes one ventricular septal defect and removes a pulmonary artery band placed during an earlier procedure to restrict pulmonary blood flow. The surgeon may close the defect directly or use a patch, depending on its anatomy. Pediatric and congenital cardiac surgeons typically perform this repair in an operating room as part of treatment for congenital heart disease.
Report the code when the operative record supports both closure of a single VSD and removal of the band; band removal alone or closure of multiple defects is a different service. Documentation should identify the defect, closure method, and band removal. The procedure has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 33688
- 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 RVU33.88 · 65%
- Practice expense (office) RVU9.74 · 19%
- Malpractice RVU8.55 · 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.
33688 compared with similar codes
Office rates for Indiana, from the same CMS release.
No office rate
This code includes pulmonary artery band removal but describes closure of multiple VSDs. Code 33688 is for closure of one defect.
33690
No office ratePulmonary artery banding
33690 describes pulmonary artery banding, whereas 33688 includes removal of a previously placed band during single-VSD closure.
Compare 33688 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
$1571.99
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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 33688 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
4,032
- Code
- 33688
- Physician work
- 33.88
- Practice expense
- 9.74
- Malpractice
- 8.55
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 33.88 | × 1.000 | 33.8800 |
| Practice expense | 9.74 | × 0.927 | 9.0290 |
| Malpractice | 8.55 | × 0.486 | 4.1553 |
| Total RVUs | 47.0643 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Indiana$1571.99
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 33.88 | 1 |
| Practice expense | 9.74 | 0.927 |
| Malpractice | 8.55 | 0.486 |
(33.88 × 1 + 9.74 × 0.927 + 8.55 × 0.486) × $33.4009 = $1571.99
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.
33688 billing questions
How does this differ from 33681?
This code includes removal of a previously placed pulmonary artery band along with closure of one VSD. Use 33681 for single-VSD closure when the service does not include band removal.
Is pulmonary artery band removal included?
Yes. The code represents single-VSD closure with band removal; do not report the removal as a separate service when it is part of that operation.
Can this code be used for multiple VSDs?
No. It describes closure of one defect. For multiple-defect closure with band removal, compare the applicable multiple-VSD code, such as 33677.
Should modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for this code; a single VSD repair is not a bilateral procedure.
What documentation supports the code and surgical assistance?
The operative report should support closure of one VSD and removal of the pulmonary artery band. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation.
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.
4,02933677,,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
4,03533694,,Cmp rpr tof wo plm atrs ptch,A,,34.68,10.96,NA,10.96,,8.74,54.38,54.38,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,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