No office rate
Both describe complete tetralogy repair without pulmonary atresia. Distinguish them by whether pulmonary artery reconstruction specified for 33694 is part of the operation.
On this page
CMS RVU26D · Effective 2026-10-01
33692 Tetralogy repair Medicare reimbursement rates in Indiana
Reports definitive surgical correction of tetralogy of Fallot when pulmonary atresia is absent, based on the documented anatomy and repair performed. Compare 33692 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 33692 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
$1631.79
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 33692: Complete repair of tetralogy of Fallot
Reports definitive surgical correction of tetralogy of Fallot when pulmonary atresia is absent, based on the documented anatomy and repair performed.
Code 33692 describes definitive open correction of tetralogy of Fallot without pulmonary atresia. A congenital cardiac surgeon typically performs the operation in a hospital operating room using cardiopulmonary bypass. The repair addresses the ventricular septal defect and obstruction to blood flow from the right ventricle to the pulmonary artery; operative techniques vary with the patient’s anatomy and may include septal patch closure and relief of outflow obstruction.
Select the code from the documented diagnosis and operative details, including whether pulmonary atresia or pulmonary artery reconstruction is present. The operative report should identify the anatomy and the corrective work performed. This major operation has a 90-day global period that includes the day-before preoperative visit and related postoperative care through day 90. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 33692
- 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 RVU35.25 · 65%
- Practice expense (office) RVU10.01 · 18%
- Malpractice RVU8.90 · 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.
33692 compared with similar codes
Office rates for Indiana, from the same CMS release.
No office rate
Use 33697 for complete tetralogy repair when pulmonary atresia is present; 33692 is for cases without pulmonary atresia.
No office rate
Code 33681 describes closure of a single VSD. Code 33692 is for complete correction of tetralogy of Fallot, including its associated outflow obstruction.
33690
No office ratePulmonary artery banding
Code 33690 describes pulmonary artery banding, a staged palliative operation; 33692 describes definitive tetralogy correction.
Compare 33692 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
$1631.79
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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 33692 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
4,034
- Code
- 33692
- Physician work
- 35.25
- Practice expense
- 10.01
- Malpractice
- 8.90
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 35.25 | × 1.000 | 35.2500 |
| Practice expense | 10.01 | × 0.927 | 9.2793 |
| Malpractice | 8.90 | × 0.486 | 4.3254 |
| Total RVUs | 48.8547 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Indiana$1631.79
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 35.25 | 1 |
| Practice expense | 10.01 | 0.927 |
| Malpractice | 8.9 | 0.486 |
(35.25 × 1 + 10.01 × 0.927 + 8.9 × 0.486) × $33.4009 = $1631.79
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.
33692 billing questions
How does 33692 differ from 33694?
Code 33692 describes complete repair without pulmonary atresia. Use 33694 when the documented repair includes pulmonary artery reconstruction as specified by that code.
Can 33692 be used when pulmonary atresia is present?
No. Code 33692 is for tetralogy of Fallot without pulmonary atresia; code 33697 is the related repair code for tetralogy with pulmonary atresia.
Is an isolated VSD closure reported as 33692?
No. Code 33692 represents complete correction of tetralogy of Fallot, not closure of an isolated ventricular septal defect. Code 33681 describes closure of a single VSD.
Does modifier 50 apply to this repair?
No. CMS identifies bilateral adjustment as inappropriate for this code; do not append modifier 50 to represent bilateral surgery.
What services are included in the global period?
The 90-day global period includes the day-before preoperative visit and related postoperative care through 90 days after surgery.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. 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.
4,03133684,,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
4,03633697,,Compl rpr tof w/pulm atresia,A,,36.63,11.34,NA,11.34,,9.24,57.21,57.21,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,03733702,,Repair of heart defects,A,,26.56,10.58,NA,10.58,,6.68,43.82,43.82,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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