No office rate
Choose 33692 for complete tetralogy repair when pulmonary atresia is absent. Pulmonary atresia is the key distinction from this code.
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CMS RVU26D · Effective 2026-10-01
33697 Tetralogy repair Medicare reimbursement rates in Maryland
Reports definitive surgical correction of tetralogy of Fallot when pulmonary atresia is present, including repair of the associated intracardiac and pulmonary outflow abnormalities. Compare 33697 office and facility rates across CMS payment localities in Maryland.
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 33697 in Maryland?
Maryland has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1902.34–$2079.23
3 of 3 localities have a supported rate.
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.
Where 33697 pays more and less in Maryland
Congenital cardiac surgery
About 33697: Complete tetralogy repair with pulmonary atresia
Reports definitive surgical correction of tetralogy of Fallot when pulmonary atresia is present, including repair of the associated intracardiac and pulmonary outflow abnormalities.
This code represents definitive surgical correction of tetralogy of Fallot with pulmonary atresia. A congenital cardiac surgeon typically performs the open-heart operation in a hospital operating room. The repair addresses the intracardiac defect and establishes or reconstructs a pathway for blood to reach the pulmonary arteries; the exact reconstruction depends on the patient’s anatomy. It is distinct from a staged palliative operation that does not complete the repair.
Select the code from the documented diagnosis and operative report, especially whether pulmonary atresia is present and what definitive repair was performed. The comprehensive service includes maneuvers integral to that repair; do not separately report those steps as independent procedures. 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, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure 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 33697
- 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 RVU36.63 · 64%
- Practice expense (office) RVU11.34 · 20%
- Malpractice RVU9.24 · 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.
33697 compared with similar codes
Office rates for Maryland, from the same CMS release.
No office rate
Choose 33694 for tetralogy repair without pulmonary atresia when pulmonary artery reconstruction is included. This code is for the repair with pulmonary atresia.
33690
No office ratePulmonary artery banding
Code 33690 describes pulmonary artery banding, a palliative operation. This code describes definitive correction of tetralogy of Fallot with pulmonary atresia.
No office rate
Code 33622 is for a redo operation for a complex cardiac anomaly. This code describes definitive tetralogy repair with pulmonary atresia, rather than a redo-specific service.
Compare 33697 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.
3 of 3 payment localities
Baltimore/Surr. Cntys →
Office / nonfacility
Unavailable
Facility
$2031.23
Dc + Md/Va Suburbs →
Office / nonfacility
Unavailable
Facility
$2079.23
Rest Of Maryland →
Office / nonfacility
Unavailable
Facility
$1902.34
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33697 billing questions
How does this differ from codes 33692 and 33694?
This code is for tetralogy of Fallot with pulmonary atresia. Codes 33692 and 33694 describe repair when pulmonary atresia is absent, with 33694 distinguishing a repair that includes pulmonary artery reconstruction.
Can a staged palliative operation be reported with this code?
Use this code for definitive correction, not for a separate operation that only provides palliation. The operative report should support that the surgeon completed the repair.
Are the repair’s component maneuvers separately reportable?
Maneuvers integral to the comprehensive repair are included in the service. Review the operative report to distinguish integral steps from any separately performed, distinct procedure.
Can modifier 50 be used?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
How are assistant and co-surgeon claims handled?
Assistant-at-surgery payment may be made. 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.
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
4,0383370F,,Ajcc brst cncr stage 0 docd,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4,03933710,,Repair of heart defects,A,,36.56,11.33,NA,11.33,,9.22,57.11,57.11,0,090,0.09,0.84,0.07,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00