No office rate
This code describes pulmonary artery unifocalization without cardiopulmonary bypass for pulmonary atresia with VSD. Choose 33920 for the repair represented by the atresia-with-VSD code rather than unifocalization alone.
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CMS RVU26D · Effective 2026-10-01
33920 Congenital heart repair Medicare reimbursement rates in Iowa
Reports surgical repair of pulmonary atresia with a ventricular septal defect, including cases with hypoplastic pulmonary arteries. Compare 33920 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 33920 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
$1497.77
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 33920: Pulmonary atresia with VSD repair
Reports surgical repair of pulmonary atresia with a ventricular septal defect, including cases with hypoplastic pulmonary arteries.
This operation treats pulmonary atresia with a ventricular septal defect, a congenital defect in which the normal route from the right ventricle to the pulmonary arteries is absent. A congenital cardiac surgeon reconstructs pulmonary blood flow and addresses the septal defect; repair may include an RV-to-pulmonary artery conduit. It is performed in an operating room, typically in a hospital, for patients requiring definitive correction of this complex heart defect.
Select the code when the operation repairs pulmonary atresia with the associated VSD, whether or not the pulmonary arteries are hypoplastic. The operative report should establish the congenital anatomy and describe the repair performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 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 33920
- 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 RVU31.92 · 63%
- Practice expense (office) RVU10.63 · 21%
- Malpractice RVU8.05 · 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.
33920 compared with similar codes
Office rates for Iowa, from the same CMS release.
No office rate
This code describes pulmonary artery unifocalization with cardiopulmonary bypass. The bypass distinction separates it from 33925; 33920 represents repair of pulmonary atresia with VSD.
No office rate
33917 is for repair of a pulmonary artery. Use 33920 when the operation is repair of pulmonary atresia with the associated VSD, not an isolated pulmonary artery repair.
Compare 33920 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
$1497.77
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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 33920 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
4,118
- Code
- 33920
- Physician work
- 31.92
- Practice expense
- 10.63
- Malpractice
- 8.05
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 31.92 | × 1.000 | 31.9200 |
| Practice expense | 10.63 | × 0.915 | 9.7265 |
| Malpractice | 8.05 | × 0.397 | 3.1959 |
| Total RVUs | 44.8423 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$1497.77
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 31.92 | 1 |
| Practice expense | 10.63 | 0.915 |
| Malpractice | 8.05 | 0.397 |
(31.92 × 1 + 10.63 × 0.915 + 8.05 × 0.397) × $33.4009 = $1497.77
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.
33920 billing questions
When is this code appropriate instead of 33925 or 33926?
Use 33920 for repair of pulmonary atresia with a VSD. Codes 33925 and 33926 describe pulmonary artery unifocalization without or with cardiopulmonary bypass, respectively.
Does pulmonary artery hypoplasia change code selection?
No. The repair represented by 33920 includes cases with or without pulmonary artery hypoplasia.
Should modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for this code.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
What documentation supports reporting 33920?
Document pulmonary atresia with the VSD and the operative work performed to repair the congenital anatomy. Include the relevant pulmonary artery anatomy, such as hypoplasia when present.
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.
4,11533915,,Remove lung artery emboli,A,,24.33,8.86,NA,8.86,,5.83,39.02,39.02,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,11633916,,Surgery of great vessel,A,,76.05,20.45,NA,20.45,,18.87,115.37,115.37,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,11733917,,Repair pulmonary artery,A,,24.67,10.72,NA,10.72,,6.21,41.60,41.60,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,11833920,,Repair pulmonary atresia,A,,31.92,10.63,NA,10.63,,8.05,50.60,50.60,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,11933922,,Transect pulmonary artery,A,,23.61,10.00,NA,10.00,,5.96,39.57,39.57,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,12033924,,Remove pulmonary shunt,A,,5.35,1.06,NA,1.06,,1.33,7.74,7.74,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,12133925,,Rpr pul art unifocal w/o cpb,A,,30.52,9.65,NA,9.65,,7.69,47.86,47.86,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,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