No office rate
Both codes describe an intraventricular tunnel repair for double-outlet right ventricle. Select 33612 when subpulmonary obstruction is also repaired; otherwise consider 33611.
On this page
CMS RVU26D · Effective 2026-10-01
33612 Cardiac repair Medicare reimbursement rates in Vermont
Reports surgical repair of double-outlet right ventricle using an intraventricular tunnel when subpulmonary obstruction is also repaired. Compare 33612 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 33612 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
$1711.88
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.
Congenital cardiac surgery
About 33612: Double-outlet right ventricle repair with obstruction repair
Reports surgical repair of double-outlet right ventricle using an intraventricular tunnel when subpulmonary obstruction is also repaired.
A cardiac surgeon uses an intraventricular tunnel to direct left ventricular blood toward the aorta in a patient with double-outlet right ventricle, and repairs associated subpulmonary obstruction during the operation. The procedure is typically performed in a hospital operating room as congenital heart surgery. The code covers the repair whether or not a ventricular septal defect is also closed as part of the operation.
Choose this code when the operative report supports both the double-outlet repair with an intraventricular tunnel and repair of subpulmonary obstruction; the tunnel repair without that obstruction repair is represented by 33611. Document the anatomy, the tunnel reconstruction, the obstruction, and the work performed to repair it. This major surgery has a 90-day global period that includes the day-before preoperative visit and 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. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 33612
- 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 RVU35.66 · 64%
- Practice expense (office) RVU11.15 · 20%
- Malpractice RVU9.00 · 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.
33612 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
33608 describes complex cardiac anomaly repair involving a conduit. It is not the tunnel repair with subpulmonary obstruction repair represented by 33612.
No office rate
33610 is defined by repair through enlargement of a ventricular septal defect. 33612 describes the double-outlet tunnel repair with subpulmonary obstruction repair.
Compare 33612 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
Vermont →
Office / nonfacility
Unavailable
Facility
$1711.88
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 33612 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
4,014
- Code
- 33612
- Physician work
- 35.66
- Practice expense
- 11.15
- Malpractice
- 9.00
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 35.66 | × 1.000 | 35.6600 |
| Practice expense | 11.15 | × 0.990 | 11.0385 |
| Malpractice | 9.00 | × 0.506 | 4.5540 |
| Total RVUs | 51.2525 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$1711.88
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 35.66 | 1 |
| Practice expense | 11.15 | 0.99 |
| Malpractice | 9 | 0.506 |
(35.66 × 1 + 11.15 × 0.99 + 9 × 0.506) × $33.4009 = $1711.88
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.
33612 billing questions
How does 33612 differ from 33611?
33612 describes the double-outlet right ventricle tunnel repair when subpulmonary obstruction is also repaired. Use 33611 for the tunnel repair without that additional obstruction repair.
Is closure of a ventricular septal defect included?
The code covers the operation with or without closure of a ventricular septal defect as part of the double-outlet repair. Do not treat an integral closure as a separate service solely because it is documented.
What documentation supports reporting 33612?
Document double-outlet right ventricular anatomy, construction of the intraventricular tunnel, the subpulmonary obstruction, and its surgical repair.
What is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
How are other same-session procedures paid?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures performed in the same session are paid at 50%.
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.
4,01133608,,Repair anomaly w/conduit,A,,31.08,11.98,NA,11.98,,7.84,50.90,50.90,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,01233610,,Repair by enlargement,A,,30.62,11.88,NA,11.88,,7.72,50.22,50.22,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,01333611,,Repair double ventricle,A,,34.68,10.96,NA,10.96,,8.74,54.38,54.38,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,01433612,,Repair double ventricle,A,,35.66,11.15,NA,11.15,,9.00,55.81,55.81,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,01533615,,Repair modified fontan,A,,34.99,12.25,NA,12.25,,8.82,56.06,56.06,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,01633617,,Repair single ventricle,A,,38.11,12.86,NA,12.86,,9.62,60.59,60.59,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,01733619,,Repair single ventricle,A,,47.54,17.60,NA,17.60,,12.00,77.14,77.14,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817