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CMS RVU26D · Effective 2026-10-01

33430 Mitral valve replacement Medicare reimbursement rates in Vermont

Report open surgical replacement when the diseased mitral valve is removed and a prosthetic valve is implanted rather than repaired. Compare 33430 office and facility rates across CMS payment localities in Vermont.

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 33430 in Vermont?

Vermont 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

$2415.30

1 of 1 localities have a supported rate.

Payment area: Vermont

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 33430 in your payment locality →

Cardiac surgery

About 33430: Open mitral valve replacement

Report open surgical replacement when the diseased mitral valve is removed and a prosthetic valve is implanted rather than repaired.

This service replaces the mitral valve during open cardiac surgery, typically using cardiopulmonary bypass. The surgeon removes the diseased valve and implants a prosthetic valve; the operation is generally performed in a hospital operating room by a cardiac surgeon. The operative report should establish that replacement, rather than repair or revision, was performed and identify the valve treated and the implanted prosthesis.

Select this code for mitral valve replacement, not for a procedure that preserves and repairs the native valve. Report other procedures performed in the same session when separately supported; under the standard multiple-procedure rule, the highest-valued procedure is paid in full and the others at 50%. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.

CMS billing rules for 33430

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 RVU49.66 · 63%
  • Practice expense (office) RVU16.62 · 21%
  • Malpractice RVU12.25 · 16%

9.5K

Medicare services in 2024 · #1503 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.

33430 compared with similar codes

Office rates for Vermont, from the same CMS release.

33425

Mitral valve repair

Without prosthetic ring

No office rate

33430 replaces the mitral valve with a prosthesis. 33425 is for mitral valve repair with bypass when the surgeon preserves the native valve.

33427

Mitral valve repair

Congenital valve repair

No office rate

Choose 33430 for valve replacement. 33427 describes mitral valve reconstruction, not implantation of a replacement valve.

33418

Mitral valve repair

Percutaneous, initial prosthesis

No office rate

33430 is open surgical replacement. 33418 describes catheter-based mitral valve repair rather than open replacement.

33405

Aortic valve replacement

Standard prosthetic valve

No office rate

33405 concerns replacement of the aortic valve; 33430 is specific to replacement of the mitral valve.

Compare 33430 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

  • Vermont →

    Office / nonfacility

    Unavailable

    Facility

    $2415.30

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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 33430 in Vermont.

PPRRVU2026_Oct_nonQPP.csv

3,956

Code
33430
Physician work
49.66
Practice expense
16.62
Malpractice
12.25

GPCI2026.csv

105

Locality
Vermont
Physician work
1.000
Practice expense
0.990
Malpractice
0.506
Facility calculation for 33430 in Vermont
ComponentRVULocality factorAdjusted
Physician work49.66× 1.00049.6600
Practice expense16.62× 0.99016.4538
Malpractice12.25× 0.5066.1985
Total RVUs72.3123
Conversion factor× 33.4009

Facility rate, Vermont$2415.30

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
Work49.661
Practice expense16.620.99
Malpractice12.250.506

(49.66 × 1 + 16.62 × 0.99 + 12.25 × 0.506) × $33.4009 = $2415.30

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.

33430 billing questions

How is replacement distinguished from mitral valve repair?

Use 33430 when the surgeon replaces the mitral valve with a prosthesis. Codes such as 33425–33427 describe mitral valve repair procedures that preserve the native valve.

What operative documentation supports 33430?

The operative report should document replacement of the mitral valve, rather than repair or revision, and identify the implanted prosthesis and any other procedures performed.

How are other procedures in the same session paid?

When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the other procedures are subject to the standard 50% multiple-procedure reduction.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

What care is included in the global period?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

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 33430PPRRVU2026_Oct_nonQPP.csv, line 3,956 (RVU26D)
Geographic factors for VermontGPCI2026.csv, line 105 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet