No office rate
Both codes describe closure of multiple VSDs. Choose 33676 when the operation also includes resection of infundibular muscle bundles; 33675 is the option without that resection.
On this page
CMS RVU26D · Effective 2026-10-01
33676 VSD repair Medicare reimbursement rates in Iowa
Reports open repair of multiple ventricular septal defects when the operation also removes obstructing infundibular muscle bundles. Compare 33676 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 33676 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
$1667.48
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.
Congenital cardiac surgery
About 33676: Multiple VSD closure with infundibular resection
Reports open repair of multiple ventricular septal defects when the operation also removes obstructing infundibular muscle bundles.
This code describes an open operation that closes multiple ventricular septal defects and includes resection of infundibular muscle bundles, which can obstruct blood flow from the right ventricle. A congenital cardiac surgeon typically performs the repair in a hospital operating room, often using cardiopulmonary bypass. The closure may use a patch or another repair technique; the defining feature is the muscle resection along with closure of multiple defects.
Report the code when the operative documentation establishes both multiple VSD closures and infundibular muscle resection. The operative report should describe the defects, the resection, and the repair performed. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 33676
- 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 RVU36.03 · 64%
- Practice expense (office) RVU11.24 · 20%
- Malpractice RVU9.09 · 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.
33676 compared with similar codes
Office rates for Iowa, from the same CMS release.
No office rate
This code is for multiple-VSD closure with infundibular muscle resection. Code 33677 is associated with removal of a pulmonary artery band during the repair.
No office rate
Code 33681 represents closure of one VSD. Code 33676 is for multiple VSDs and includes infundibular muscle resection.
Compare 33676 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
$1667.48
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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 33676 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
4,028
- Code
- 33676
- Physician work
- 36.03
- Practice expense
- 11.24
- Malpractice
- 9.09
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 36.03 | × 1.000 | 36.0300 |
| Practice expense | 11.24 | × 0.915 | 10.2846 |
| Malpractice | 9.09 | × 0.397 | 3.6087 |
| Total RVUs | 49.9233 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$1667.48
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 36.03 | 1 |
| Practice expense | 11.24 | 0.915 |
| Malpractice | 9.09 | 0.397 |
(36.03 × 1 + 11.24 × 0.915 + 9.09 × 0.397) × $33.4009 = $1667.48
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.
33676 billing questions
How does this differ from 33675?
Use 33676 when the multiple-VSD repair includes resection of infundibular muscle bundles. Code 33675 describes multiple-VSD closure without that resection.
Can this code be used for a single VSD?
No. This code is for closure of multiple ventricular septal defects. A single-defect repair is represented by a different code, with selection based on the operation performed.
Does the code include the muscle resection?
Yes. The infundibular muscle resection is part of the service represented by this code when performed with closure of multiple VSDs.
What should the operative report document?
Document the multiple VSDs, their closure, and the infundibular muscle bundles resected. The record should make clear that the resection was performed as part of the repair.
How is another procedure in the same session paid?
Under CMS's standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; CMS does not permit team surgery for this code.
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.
4,02533665,,Repair of heart defects,A,,33.98,10.82,NA,10.82,,8.58,53.38,53.38,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,02633670,,Repair of heart chambers,A,,35.71,9.74,NA,9.74,,9.00,54.45,54.45,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,02733675,,Close mult vsd,A,,35.05,11.06,NA,11.06,,8.84,54.95,54.95,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,02833676,,Close mult vsd w/resection,A,,36.03,11.24,NA,11.24,,9.09,56.36,56.36,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,02933677,,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
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