Billing code 33496: Valve thrombus repairMedicare rate & RVUs in Utah
Open cardiac surgery with cardiopulmonary bypass to clear thrombus affecting an existing prosthetic heart valve when the valve is repaired rather than replaced.
CMS doesn’t publish an office rate for 33496 in Utah.
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 33496 covers
A cardiac surgeon uses cardiopulmonary bypass to address thrombus obstructing or impairing an implanted prosthetic heart valve. The operation treats the clot-related problem while retaining and repairing the prosthesis, rather than removing it for valve replacement. It is a facility-based cardiac surgery service, not a separately reported diagnostic or catheter-based clot treatment.
Report the code when the operative work addresses thrombus involving a prosthetic valve. The operative report should identify the affected valve, document the thrombus and the repair performed, and clarify whether the prosthesis was retained or replaced. Medicare 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. Assistant-at-surgery payment may be available; 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.
33496 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | Unavailable | $1,539.86 |
How the 33496 rate is calculated
Each of 33496’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 · 33496
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 29.09Practice expense 11.43Malpractice 6.98
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 33496
33496 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33496
Valve thrombus 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 · 33496
Valve thrombus 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
33496 without 51 · national facility
$1,586.54
Valve thrombus repair
33496-51 · Second procedure: 50%
$793.27
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%).
33496 compared with similar codes
Compare codes
33496 vs 33413 vs 33430 vs 33414: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 33413Aortic valve replacement
- This code addresses thrombus involving a prosthetic valve that is repaired and retained. Code 33413 is for aortic valve replacement, not clot-directed repair.
- 33430Mitral valve replacement
- Use this code for thrombus-related repair of a retained prosthetic valve. Code 33430 applies when the mitral valve is replaced.
- 33414Aortic valve repair
- Code 33414 concerns aortic valve repair; this code is specific to thrombus involving an existing prosthetic heart valve.
33496 billing questions
How is this code distinguished from a valve replacement code?
Use this code when surgery treats thrombus affecting a prosthetic valve and the valve is retained and repaired. If the surgeon removes the prosthesis and implants a replacement, select the applicable replacement code instead.
Does this code include replacement of the prosthetic valve?
No. It describes repair directed at the thrombus problem with the prosthesis retained; replacement is a different operative service.
What documentation supports reporting this service?
The operative report should identify the prosthetic valve involved, describe the thrombus and the repair, and make clear whether the prosthesis was retained or replaced.
How does the 90-day global period affect postoperative reporting?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. 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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