Billing code 33688: VSD closureMedicare rate & RVUs in Oregon
Reports surgical closure of one ventricular septal defect together with removal of a previously placed pulmonary artery band.
CMS doesn’t publish an office rate for 33688 in Oregon.
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 33688 covers
This code describes an operation that closes one ventricular septal defect and removes a pulmonary artery band placed during an earlier procedure to restrict pulmonary blood flow. The surgeon may close the defect directly or use a patch, depending on its anatomy. Pediatric and congenital cardiac surgeons typically perform this repair in an operating room as part of treatment for congenital heart disease.
Report the code when the operative record supports both closure of a single VSD and removal of the band; band removal alone or closure of multiple defects is a different service. Documentation should identify the defect, closure method, and band removal. The procedure has 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 others at 50%. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeons require 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.
Where 33688 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $1,723.63 |
| Rest Of Oregon | Unavailable | $1,656.41 |
How the 33688 rate is calculated
Each of 33688’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 · 33688
RVUs × geographic indexes × conversion factor
Work33.88
33.88 RVUs× 1.000 GPCI
Practice expense9.74
9.74 RVUs× 1.000 GPCI
Malpractice8.55
8.55 RVUs× 1.000 GPCI
Adjusted RVUs
52.1700
Conversion factor
$33.4009
Medicare rate
$1,742.52
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33688
33688 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33688
VSD closure
| 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 · 33688
VSD closure
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
33688 without 51 · national facility
$1,742.52
VSD closure
33688-51 · Second procedure: 50%
$871.26
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%).
33688 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 33681VSD closure
- Both describe closure of one VSD, but 33688 includes removal of a pulmonary artery band. Choose 33681 when that band-removal service is not part of the operation.
- 33677VSD repair
- This code includes pulmonary artery band removal but describes closure of multiple VSDs. Code 33688 is for closure of one defect.
- 33690Pulmonary artery banding
- 33690 describes pulmonary artery banding, whereas 33688 includes removal of a previously placed band during single-VSD closure.
33688 billing questions
How does this differ from 33681?
This code includes removal of a previously placed pulmonary artery band along with closure of one VSD. Use 33681 for single-VSD closure when the service does not include band removal.
Is pulmonary artery band removal included?
Yes. The code represents single-VSD closure with band removal; do not report the removal as a separate service when it is part of that operation.
Can this code be used for multiple VSDs?
No. It describes closure of one defect. For multiple-defect closure with band removal, compare the applicable multiple-VSD code, such as 33677.
Should modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for this code; a single VSD repair is not a bilateral procedure.
What documentation supports the code and surgical assistance?
The operative report should support closure of one VSD and removal of the pulmonary artery band. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation.
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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