Billing code 33418: Mitral valve repairMedicare rate & RVUs in Nebraska
Reports catheter-based repair of mitral regurgitation using an initial prosthesis, including transseptal access when performed, during a structural heart procedure.
CMS doesn’t publish an office rate for 33418 in Nebraska.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 33418 covers
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.
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 in Nebraska
| Payment locality | Office | Facility |
|---|---|---|
| Nebraska | Unavailable | $1,404.75 |
How the 33418 rate is calculated
Each of 33418’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 33418
RVUs × geographic indexes × conversion factor
Work31.44
31.44 RVUs× 1.000 GPCI
Practice expense8.46
8.46 RVUs× 1.000 GPCI
Malpractice7.43
7.43 RVUs× 1.000 GPCI
Adjusted RVUs
47.3300
Conversion factor
$33.4009
Medicare rate
$1,580.86
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33418
33418 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33418
Mitral valve repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.84/0.07 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 33418
Mitral valve repair
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
33418 without 51 · national facility
$1,580.86
Mitral valve repair
33418-51 · Second procedure: 50%
$790.43
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
33418 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 33419Mitral repair
- 33418 represents the initial prosthesis in the transcatheter repair; 33419 is used for each additional prosthesis.
- 33425Mitral valve repair
- Use 33418 for percutaneous transcatheter mitral repair. Code 33425 describes open surgical mitral valve repair.
- 33426Mitral valve repair
- Both codes concern mitral valve repair, but 33418 is for the percutaneous transcatheter approach and 33426 is an open surgical repair.
- 33430Mitral valve replacement
- 33418 repairs the mitral valve by a transcatheter approach; 33430 describes mitral valve replacement.
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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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