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CMS RVU26D · Effective 2026-10-01

33677 VSD repair Medicare reimbursement rates in Tennessee

Open repair closes multiple ventricular septal defects and removes a pulmonary artery band during the same operation, typically as staged congenital heart surgery. Compare 33677 office and facility rates across CMS payment localities in Tennessee.

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 33677 in Tennessee?

Tennessee has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.

Office / nonfacility

No supported rate

Facility setting

$1771.59

1 of 1 localities have a supported rate.

Payment area: Tennessee

One mapped payment locality.

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 33677 in your payment locality →

Congenital cardiac surgery

About 33677: Multiple VSD closure with band removal

Open repair closes multiple ventricular septal defects and removes a pulmonary artery band during the same operation, typically as staged congenital heart surgery.

A congenital cardiac surgeon uses this code for an operation that closes multiple ventricular septal defects and removes a previously placed pulmonary artery band. This combination may occur in staged treatment of an infant or child whose band was used to control excessive pulmonary blood flow before definitive repair. The procedure is performed in a hospital operating room and may involve open-heart surgical techniques.

Report the code when the operative record supports both closure of multiple VSDs and removal of the band during the same operation. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this service.

CMS billing rules for 33677

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 RVU37.49 · 64%
  • Practice expense (office) RVU11.53 · 20%
  • Malpractice RVU9.44 · 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.

33677 compared with similar codes

Office rates for Tennessee, from the same CMS release.

33675

VSD closure

Multiple defects, no specified adjunct

No office rate

Choose 33675 for closure of multiple VSDs without pulmonary artery band removal. 33677 captures the combined repair and removal.

33676

VSD repair

Multiple defects with resection

No office rate

33676 is the multiple-VSD closure code associated with resection. Select 33677 when the documented combination is multiple VSD closure and pulmonary artery band removal.

33688

VSD closure

Single defect, band removal

No office rate

33688 combines band removal with closure of a single VSD; 33677 is for multiple VSDs closed during the operation.

33681

VSD closure

One defect, with or without patch

No office rate

33681 is for closure of one VSD without the band-removal combination. It is not the choice when multiple VSDs are closed and the band is removed.

Compare 33677 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.

1 of 1 payment localities

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

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How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 33677 in Tennessee.

PPRRVU2026_Oct_nonQPP.csv

4,029

Code
33677
Physician work
37.49
Practice expense
11.53
Malpractice
9.44

GPCI2026.csv

95

Locality
Tennessee
Physician work
1.000
Practice expense
0.909
Malpractice
0.537
Facility calculation for 33677 in Tennessee
ComponentRVULocality factorAdjusted
Physician work37.49× 1.00037.4900
Practice expense11.53× 0.90910.4808
Malpractice9.44× 0.5375.0693
Total RVUs53.0401
Conversion factor× 33.4009

Facility rate, Tennessee$1771.59

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.
Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work37.491
Practice expense11.530.909
Malpractice9.440.537

(37.49 × 1 + 11.53 × 0.909 + 9.44 × 0.537) × $33.4009 = $1771.59

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

33677 billing questions

How does this differ from 33675?

33677 includes removal of a pulmonary artery band along with closure of multiple VSDs. 33675 describes closure of multiple VSDs without that band-removal element.

Is removal of the pulmonary artery band separately reported?

Band removal is part of the service represented by 33677 when performed with closure of the multiple VSDs. Do not separately report that same removal as a stand-alone service for the combined operation.

When is 33688 a closer choice?

33688 describes closure of a single VSD with removal of a pulmonary artery band. Use 33677 when multiple VSDs are closed and the band is removed.

Can modifier 50 be used?

No. The CMS bilateral adjustment does not apply to this code, 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 performed in that session are paid at 50%.

What supports reporting 33677?

The operative report should establish that multiple VSDs were closed and a previously placed pulmonary artery band was removed in the same operation.

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 33677PPRRVU2026_Oct_nonQPP.csv, line 4,029 (RVU26D)
Geographic factors for TennesseeGPCI2026.csv, line 95 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet