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CMS RVU26D · Effective 2026-10-01

33468 Tricuspid valve surgery Medicare reimbursement rates in Michigan

Surgical revision of the tricuspid valve is reported when the surgeon reworks prior valve surgery rather than performing a primary repair or replacement. Compare 33468 office and facility rates across CMS payment localities in Michigan.

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 33468 in Michigan?

Michigan 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

$2282.05–$2511.32

2 of 2 localities have a supported rate.

Lowest: Rest Of Michigan

Highest: Detroit

A spread of $229.27 per service.

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.

Find 33468 in your payment locality →

Cardiac surgery

About 33468: Surgical tricuspid valve revision

Surgical revision of the tricuspid valve is reported when the surgeon reworks prior valve surgery rather than performing a primary repair or replacement.

This service involves an operation to revise the tricuspid valve, typically when prior valve surgery requires further surgical correction. A cardiothoracic surgeon performs the procedure in a surgical setting. The operative report should identify the prior valve intervention and describe the tricuspid valve work performed. Report this code for revision of the valve, not simply because the patient has tricuspid valve disease or a history of cardiac surgery.

Select the code based on the operation documented, distinguishing revision from a new valve repair or replacement. Medicare assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. 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 50% multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

CMS billing rules for 33468

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 RVU44.00 · 65%
  • Practice expense (office) RVU12.89 · 19%
  • Malpractice RVU11.12 · 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.

33468 compared with similar codes

Office rates for Michigan, from the same CMS release.

33463

Tricuspid repair

With ring insertion

No office rate

This code is for revision of prior tricuspid valve surgery; 33463 describes a tricuspid valve repair. Follow the operative report.

33464

Tricuspid repair

With cardiopulmonary bypass

No office rate

Use this code for valve revision, not for the tricuspid repair service represented by 33464.

33465

Valve replacement

Tricuspid valve

No office rate

33465 is used when the tricuspid valve is replaced. This code is for revision rather than replacement.

33420

Mitral valvotomy

Closed surgical approach

No office rate

Both describe valve revision, but 33420 concerns the mitral valve; this code concerns the tricuspid valve.

Compare 33468 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

Office and facility base rates · shared scale starting at $0

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33468 billing questions

How is revision distinguished from tricuspid valve repair?

Use this code when the documented operation revises prior tricuspid valve surgery. Select a repair code when the surgeon performs a repair rather than a revision.

When should a tricuspid valve replacement code be used instead?

Use the replacement code when the operation replaces the valve. This code describes revision, not replacement.

Are the preoperative and postoperative visits separately reported?

The day-before preoperative visit and 90 days of related postoperative care are included in the 90-day global period.

Can modifier 50 be reported?

No. Modifier 50 is inappropriate for this tricuspid valve procedure.

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?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure 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.

RVUs for 33468PPRRVU2026_Oct_nonQPP.csv, line 3,965 (RVU26D)