No office rate
33418 represents the initial prosthesis in the transcatheter repair; 33419 is used for each additional prosthesis.
On this page
CMS RVU26D · Effective 2026-10-01
33418 Mitral valve repair Medicare reimbursement rates in Massachusetts
Reports catheter-based repair of mitral regurgitation using an initial prosthesis, including transseptal access when performed, during a structural heart procedure. Compare 33418 office and facility rates across CMS payment localities in Massachusetts.
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 33418 in Massachusetts?
Massachusetts has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1562.26–$1651.44
2 of 2 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.
Cardiothoracic surgery
About 33418: Percutaneous transcatheter mitral valve repair
Reports catheter-based repair of mitral regurgitation using an initial prosthesis, including transseptal access when performed, during a structural heart procedure.
This code covers a catheter-based mitral valve repair, commonly a transcatheter edge-to-edge procedure for mitral regurgitation. A structural heart team, typically including an interventional cardiologist and cardiac surgeon, performs it in a hospital catheterization laboratory or hybrid operating room. The catheter is advanced to the mitral valve, often through transseptal access, and a prosthesis is used to improve leaflet coaptation. The code includes the transseptal puncture when performed.
Report 33418 for the initial prosthesis; report 33419 for each additional prosthesis. The operative report should support the percutaneous approach, mitral valve repair, and prosthesis use. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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 made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 33418
- 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 RVU31.44 · 66%
- Practice expense (office) RVU8.46 · 18%
- Malpractice RVU7.43 · 16%
10.8K
Medicare services in 2024 · #1436 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.
33418 compared with similar codes
Office rates for Massachusetts, from the same CMS release.
No office rate
Use 33418 for percutaneous transcatheter mitral repair. Code 33425 describes open surgical mitral valve repair.
No office rate
Both codes concern mitral valve repair, but 33418 is for the percutaneous transcatheter approach and 33426 is an open surgical repair.
No office rate
33418 repairs the mitral valve by a transcatheter approach; 33430 describes mitral valve replacement.
Compare 33418 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.
2 of 2 payment localities
Metropolitan Boston →
Office / nonfacility
Unavailable
Facility
$1651.44
Rest Of Massachusetts →
Office / nonfacility
Unavailable
Facility
$1562.26
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33418 billing questions
When is 33419 reported with 33418?
Report 33418 for the initial prosthesis and 33419 for each additional prosthesis. The operative report should support the number of prostheses used.
Is transseptal puncture separately reported?
Transseptal puncture, when performed for this repair, is included in 33418.
How does 33418 differ from 33425 through 33427?
33418 describes a percutaneous transcatheter repair. Codes 33425 through 33427 describe open surgical mitral valve repair procedures.
Should modifier 50 be appended?
No. Bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What happens when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction.
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.
3,94433415,,Revision subvalvular tissue,A,,36.34,11.67,NA,11.67,,9.00,57.01,57.01,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,94533416,,Revise ventricle muscle,A,,35.65,12.53,NA,12.53,,8.77,56.95,56.95,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,94633417,,Repair of aortic valve,A,,28.60,11.49,NA,11.49,,7.22,47.31,47.31,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,94733418,,Repair tcat mitral valve,A,,31.44,8.46,NA,8.46,,7.43,47.33,47.33,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,94833419,,Repair tcat mitral valve,A,,7.73,1.47,NA,1.47,,1.82,11.02,11.02,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,9493341F,,Mammo assess negative 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
3,95033420,,Revision of mitral valve,A,,25.15,10.36,NA,10.36,,6.02,41.53,41.53,0,090,0.09,0.84,0.07,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00