No office rate
This code is for excision of an intracardiac tumor under that code’s specific classification. Choose based on the documented procedure, not simply the presence of a cardiac mass.
On this page
CMS RVU26D · Effective 2026-10-01
33542 Heart lesion removal Medicare reimbursement rates in Utah
Reports surgical removal of a discrete heart lesion, such as a cardiac mass, when the operative work supports excision rather than repair or ventricular remodeling. Compare 33542 office and facility rates across CMS payment localities in Utah.
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 33542 in Utah?
Utah 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
$2386.19
1 of 1 localities have a supported rate.
Payment area: Utah
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.
Cardiac surgery
About 33542: Surgical removal of a cardiac lesion
Reports surgical removal of a discrete heart lesion, such as a cardiac mass, when the operative work supports excision rather than repair or ventricular remodeling.
This code represents a surgeon’s operative removal of a lesion from the heart. A typical clinical situation is excision of a cardiac mass, such as a tumor, during open cardiac surgery. Cardiothoracic surgeons generally perform the procedure in a hospital operating room; the operative report should identify the lesion, its location, and the work used to remove it.
Select the code based on the documented procedure, not the diagnosis alone. The operative note should distinguish lesion excision from repair of damaged heart tissue or a ventricular restoration procedure. 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% multiple-procedure reduction. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this code.
CMS billing rules for 33542
- 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 RVU47.00 · 64%
- Practice expense (office) RVU14.90 · 20%
- Malpractice RVU11.62 · 16%
132
Medicare services in 2024 · #4651 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.
33542 compared with similar codes
Office rates for Utah, from the same CMS release.
No office rate
This code classifies intraventricular tumor excision specifically. The operative report’s anatomic site and procedure determine whether it applies instead.
No office rate
This code describes surgical ventricular restoration, not removal of a discrete heart lesion. Use it when ventricular restoration is the procedure performed.
Compare 33542 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
Utah →
Office / nonfacility
Unavailable
Facility
$2386.19
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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 33542 in Utah.
PPRRVU2026_Oct_nonQPP.csv
4,003
- Code
- 33542
- Physician work
- 47.00
- Practice expense
- 14.90
- Malpractice
- 11.62
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 47.00 | × 1.000 | 47.0000 |
| Practice expense | 14.90 | × 0.940 | 14.0060 |
| Malpractice | 11.62 | × 0.898 | 10.4348 |
| Total RVUs | 71.4408 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Utah$2386.19
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 47 | 1 |
| Practice expense | 14.9 | 0.94 |
| Malpractice | 11.62 | 0.898 |
(47 × 1 + 14.9 × 0.94 + 11.62 × 0.898) × $33.4009 = $2386.19
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.
33542 billing questions
How is this code distinguished from codes 33120 and 33130?
Use the code that matches the documented cardiac lesion procedure and its anatomic details. Codes 33120 and 33130 describe more specifically classified intracardiac or intraventricular tumor excisions; do not choose this code based only on a general diagnosis of a heart mass.
Does the 90-day global period include postoperative visits?
Yes. Related postoperative care during the 90 days after surgery is included, along with the day-before preoperative visit.
Can this procedure be reported with another cardiac procedure in the same session?
When separately performed procedures are reported together, Medicare applies the standard multiple-procedure reduction: the highest-valued procedure is paid in full and the others are subject to a 50% reduction.
Can modifier 50 be used for removal of lesions on both sides?
No. The descriptor and anatomy make bilateral adjustment inappropriate for this code.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
What documentation supports reporting this code?
The operative report should describe the lesion’s location and the surgical work performed to excise it, and should make clear how that work differs from any separately reported repair or ventricular restoration.
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.
4,00033535,,Cabg arterial three,A,,43.63,14.08,NA,14.08,,10.72,68.43,68.43,0,090,0.09,0.82,0.09,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,00133536,,Cabg arterial four or more,A,,47.22,14.80,NA,14.80,,11.65,73.67,73.67,0,090,0.09,0.82,0.09,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,0023353F,,Mild-mod dep symp by deptool,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
4,00333542,,Removal of heart lesion,A,,47.00,14.90,NA,14.90,,11.62,73.52,73.52,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,00433545,,Repair of heart damage,A,,55.63,16.88,NA,16.88,,13.36,85.87,85.87,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,00533548,,Restore/remodel ventricle,A,,52.79,17.63,NA,17.63,,12.68,83.10,83.10,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,0063354F,,Clin sig dep sym by dep tool,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
10104412,TX,15,GALVESTON,1.008,0.993,0.828
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985