No office rate
Both are open aortic valve valvuloplasty procedures with cardiopulmonary bypass. The documented transventricular approach distinguishes 33391.
On this page
CMS RVU26D · Effective 2026-10-01
33390 Aortic valvuloplasty Medicare reimbursement rates in Iowa
Open aortic valve valvuloplasty repairs a narrowed native valve while preserving it, typically during cardiac surgery using cardiopulmonary bypass. Compare 33390 office and facility rates across CMS payment localities in Iowa.
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 33390 in Iowa?
Iowa 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
$1574.73
1 of 1 localities have a supported rate.
Payment area: Iowa
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 33390: Open aortic valve valvuloplasty
Open aortic valve valvuloplasty repairs a narrowed native valve while preserving it, typically during cardiac surgery using cardiopulmonary bypass.
This operation widens or repairs a narrowed native aortic valve while preserving the valve rather than replacing it. A cardiothoracic surgeon performs the repair in an operating room, commonly for aortic stenosis when the surgical plan is to improve valve opening. The procedure uses cardiopulmonary bypass. The operative report should describe the valve abnormality, repair performed, and surgical approach; code 33391 is the related transventricular approach.
Report 33390 when the documented procedure matches its open, bypass-supported approach. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, Medicare pays the highest-valued procedure in full and reduces others to 50%. An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, while team surgery is not permitted.
CMS billing rules for 33390
- 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 RVU34.13 · 64%
- Practice expense (office) RVU10.62 · 20%
- Malpractice RVU8.31 · 16%
289
Medicare services in 2024 · #4025 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.
33390 compared with similar codes
Office rates for Iowa, from the same CMS release.
Compare 33390 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
Iowa →
Office / nonfacility
Unavailable
Facility
$1574.73
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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 33390 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
3,933
- Code
- 33390
- Physician work
- 34.13
- Practice expense
- 10.62
- Malpractice
- 8.31
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 34.13 | × 1.000 | 34.1300 |
| Practice expense | 10.62 | × 0.915 | 9.7173 |
| Malpractice | 8.31 | × 0.397 | 3.2991 |
| Total RVUs | 47.1464 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$1574.73
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 34.13 | 1 |
| Practice expense | 10.62 | 0.915 |
| Malpractice | 8.31 | 0.397 |
(34.13 × 1 + 10.62 × 0.915 + 8.31 × 0.397) × $33.4009 = $1574.73
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.
33390 billing questions
How does 33390 differ from 33391?
Both describe open aortic valve valvuloplasty with cardiopulmonary bypass. Use 33391 when the operative report documents the transventricular approach; use 33390 for the other approach described by its code.
When should the repair be coded as valve replacement instead?
Use a replacement code when the surgeon removes or replaces the native aortic valve rather than repairing and preserving it. The operative report should establish which procedure was performed.
What documentation supports 33390?
Document the aortic valve condition, the repair performed, the open approach, and use of cardiopulmonary bypass. Include enough operative detail to distinguish the procedure from the transventricular approach represented by 33391.
How does the 90-day global period affect related care?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. 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 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.
3,93033368,,Replace aortic valve w/byp,A,,14.03,2.88,NA,2.88,,3.35,20.26,20.26,0,ZZZ,0.00,0.00,0.00,0,0,0,0,1,9,,33.4009,09,0,99,0.00,0.00,0.00
3,93133369,,Replace aortic valve w/byp,A,,18.53,3.80,NA,3.80,,4.44,26.77,26.77,0,ZZZ,0.00,0.00,0.00,0,0,0,0,1,9,,33.4009,09,0,99,0.00,0.00,0.00
3,93233370,,Tcat plmt&rmvl cepd perq,A,,2.44,0.46,NA,0.46,,0.57,3.47,3.47,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,93333390,,Valvuloplasty aortic valve,A,,34.13,10.62,NA,10.62,,8.31,53.06,53.06,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,93433391,,Valvuloplasty aortic valve,A,,40.46,13.28,NA,13.28,,9.71,63.45,63.45,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,93533404,,Prepare heart-aorta conduit,A,,30.59,11.92,NA,11.92,,7.33,49.84,49.84,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,93633405,,Replacement aortic valve opn,A,,40.29,13.38,NA,13.38,,9.98,63.65,63.65,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136