No office rate
Both codes describe tricuspid valve repair with cardiopulmonary bypass. Choose 33463 when a ring is inserted; 33464 is for repair without ring insertion.
On this page
CMS RVU26D · Effective 2026-10-01
33463 Tricuspid repair Medicare reimbursement rates in Texas
Reports open tricuspid valve repair using a ring to support the valve, typically during cardiac surgery with cardiopulmonary bypass. Compare 33463 office and facility rates across CMS payment localities in Texas.
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 33463 in Texas?
Texas has 8 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 8 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
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.
Where 33463 pays more and less in Texas
Cardiac surgery
About 33463: Tricuspid valve repair with ring
Reports open tricuspid valve repair using a ring to support the valve, typically during cardiac surgery with cardiopulmonary bypass.
This code describes surgical repair of the tricuspid valve with insertion of a ring, generally to support or reshape the valve annulus and address tricuspid regurgitation. A cardiac surgeon performs the repair in an operating room, typically with cardiopulmonary bypass. It may be part of surgery addressing more than one heart valve when each repair is performed and documented.
Select this code when the tricuspid repair includes ring insertion; the corresponding repair without a ring is reported with 33464. The operative report should identify the tricuspid valve, the repair performed, and the ring insertion. Medicare assigns a 90-day global period, including 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 other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is not appropriate. Assistant-at-surgery payment may be allowed; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 33463
- 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 RVU55.65 · 65%
- Practice expense (office) RVU16.58 · 19%
- Malpractice RVU13.56 · 16%
376
Medicare services in 2024 · #3788 by national volume
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.
33463 compared with similar codes
Office rates for Texas, from the same CMS release.
No office rate
33463 repairs the native tricuspid valve with ring insertion. 33465 is for replacement of the tricuspid valve.
No office rate
33427 describes repair of the mitral valve, not the tricuspid valve. Identify the valve treated in the operative report.
Compare 33463 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.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Office Unavailable | Facility $2849.67 |
| Beaumont | Office Unavailable | Facility $2783.47 |
| Brazoria | Office Unavailable | Facility $2775.71 |
| Dallas | Office Unavailable | Facility $2815.66 |
| Fort Worth | Office Unavailable | Facility $2816.01 |
| Galveston | Office Unavailable | Facility $2798.56 |
| Houston | Office Unavailable | Facility $3046.75 |
| Rest Of Texas | Office Unavailable | Facility $2793.29 |
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33463 billing questions
When should 33463 be chosen instead of 33464?
Use 33463 when the tricuspid valve repair includes insertion of a ring. Use 33464 for the corresponding repair without ring insertion.
Does this code describe tricuspid valve replacement?
No. It describes repair with ring insertion. Tricuspid valve replacement is reported with 33465.
What documentation supports reporting 33463?
The operative report should identify the tricuspid valve repair and document insertion of the ring. It should also describe the performed procedures when multiple procedures are reported for the same session.
How does the multiple-procedure rule affect payment?
When multiple procedures are performed in the same session, Medicare pays the highest-valued procedure in full and applies the standard 50% reduction to the others.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be allowed. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
Is modifier 50 appropriate for this tricuspid repair?
No. The bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
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.
3,9593344F,,Mammo assess susp docd,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
3,9603345F,,Mammo assess hghlymalig doc,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
3,96133460,,Revision of tricuspid valve,A,,43.58,13.15,NA,13.15,,10.46,67.19,67.19,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,96233463,,Valvuloplasty tricuspid,A,,55.65,16.58,NA,16.58,,13.56,85.79,85.79,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,96333464,,Valvuloplasty tricuspid,A,,43.50,14.11,NA,14.11,,10.43,68.04,68.04,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,96433465,,Replace tricuspid valve,A,,49.45,15.21,NA,15.21,,12.10,76.76,76.76,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,96533468,,Revision of tricuspid valve,A,,44.00,12.89,NA,12.89,,11.12,68.01,68.01,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00