Billing code 33422: Mitral valvotomyMedicare rate & RVUs in Ohio
Reports open surgical division of fused mitral valve commissures under cardiopulmonary bypass to relieve stenosis while preserving the native valve.
CMS doesn’t publish an office rate for 33422 in Ohio.
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 33422 covers
A cardiac surgeon performs an open mitral valvotomy with cardiopulmonary bypass, directly addressing the stenotic valve and separating fused commissures to improve valve opening. This operation is used for selected patients with mitral stenosis when the native valve can be preserved; commissural fusion, often associated with rheumatic disease, is a typical finding. It is generally performed in a hospital operating room.
Choose this code for the open operation with bypass, not for a closed valvotomy, mitral valve repair, or valve replacement. The operative report should establish the open approach, use of bypass, stenotic pathology, and the valvotomy performed. 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 others at 50%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation. 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.
33422 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $1,556.36 |
How the 33422 rate is calculated
Each of 33422’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 · 33422
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 28.99Practice expense 11.60Malpractice 6.96
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 33422
33422 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33422
Mitral valvotomy
| 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 · 33422
Mitral valvotomy
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
33422 without 51 · national facility
$1,588.21
Mitral valvotomy
33422-51 · Second procedure: 50%
$794.11
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%).
33422 compared with similar codes
Compare codes
33422 vs 33420 vs 33425 vs 33430: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 33420Mitral valvotomy
- 33420 is the closed-heart mitral valvotomy code. Report 33422 when the surgeon performs the open operation with cardiopulmonary bypass.
- 33425Mitral valve repair
- 33425 describes mitral valve repair with annuloplasty. It is not the code for dividing fused commissures to relieve stenosis.
- 33430Mitral valve replacement
- 33430 is for mitral valve replacement. 33422 preserves the native valve and opens it through valvotomy.
33422 billing questions
How does 33422 differ from 33420?
33422 describes open mitral valvotomy with cardiopulmonary bypass. 33420 is the closed-heart mitral valvotomy code.
When is mitral repair or replacement reported instead?
Use a repair code when the operation reconstructs the valve rather than dividing fused commissures. Use a replacement code when the native valve is removed and replaced.
What should the operative report support?
Document the open approach, cardiopulmonary bypass, mitral stenosis, and the valve-opening procedure performed. The diagnosis alone does not establish that this operation was done.
Can modifier 50 be reported?
No. The bilateral adjustment does not apply to this single mitral valve operation, and modifier 50 is inappropriate.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%. The 90-day global period includes related postoperative care.
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.
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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