No office rate
Choose 33420 for closed surgical commissurotomy. Choose 33422 when the mitral valve is treated by open-heart valvotomy with cardiopulmonary bypass.
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CMS RVU26D · Effective 2026-10-01
33420 Mitral valvotomy Medicare reimbursement rates in Virginia
Reports closed surgical opening of fused mitral valve commissures to relieve stenosis, typically in patients with rheumatic mitral valve disease. Compare 33420 office and facility rates across CMS payment localities in Virginia.
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 33420 in Virginia?
Virginia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1322.14–$1516.82
2 of 2 localities have a 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.
Cardiac surgery
About 33420: Closed mitral valve valvotomy
Reports closed surgical opening of fused mitral valve commissures to relieve stenosis, typically in patients with rheumatic mitral valve disease.
This code describes a closed surgical mitral valvotomy, also called a commissurotomy, in which fused areas of the mitral valve are separated to improve blood flow through a narrowed valve. Cardiothoracic surgeons have traditionally performed it for mitral stenosis, often related to rheumatic disease. The surgeon works without opening the heart to directly visualize the valve; this distinguishes the procedure from an open-heart valvotomy and from catheter-based valve treatment.
Report the code when the operative report supports a closed valvotomy to relieve mitral stenosis, not a valve repair or replacement. Documentation should identify the stenotic valve and describe the surgical approach and commissural separation. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. 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 is restricted by statute; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 33420
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU25.15 · 61%
- Practice expense (office) RVU10.36 · 25%
- Malpractice RVU6.02 · 14%
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.
33420 compared with similar codes
Office rates for Virginia, from the same CMS release.
No office rate
Code 33425 describes mitral valve repair, not commissural separation for stenosis. Select based on the operation documented.
No office rate
Code 33430 is for mitral valve replacement. It is not the code for a closed procedure that opens fused commissures while retaining the native valve.
Compare 33420 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.
2 of 2 payment localities
Dc + Md/Va Suburbs →
Office / nonfacility
Unavailable
Facility
$1516.82
Virginia →
Office / nonfacility
Unavailable
Facility
$1322.14
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33420 billing questions
How is this different from 33422?
Both codes describe mitral valvotomy, but 33420 is for the closed surgical approach. Code 33422 is for an open-heart valvotomy performed with cardiopulmonary bypass.
When should a mitral repair code be used instead?
Use a repair code when the operation reconstructs the mitral valve rather than separating fused commissures to relieve stenosis. The operative report should establish the procedure actually performed.
Is postoperative care included?
Yes. The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
Can this be reported with another procedure performed in the same session?
When multiple procedures are performed in the same session, CMS pays the highest-valued procedure in full and applies the standard 50% reduction to the others.
What documentation supports co-surgeon billing?
Co-surgeon payment requires supporting documentation. The operative record should substantiate the surgeons’ roles in this mitral valve procedure.
Can an assistant surgeon be paid for this procedure?
CMS statutory restrictions bar assistant-at-surgery payment for this code. Team-surgery payment is not permitted.
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.
3,94733418,,Repair tcat mitral valve,A,,31.44,8.46,NA,8.46,,7.43,47.33,47.33,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,94833419,,Repair tcat mitral valve,A,,7.73,1.47,NA,1.47,,1.82,11.02,11.02,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,9493341F,,Mammo assess negative 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
3,95033420,,Revision of mitral valve,A,,25.15,10.36,NA,10.36,,6.02,41.53,41.53,0,090,0.09,0.84,0.07,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,95133422,,Revision of mitral valve,A,,28.99,11.60,NA,11.60,,6.96,47.55,47.55,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,95233425,,Repair of mitral valve,A,,48.71,15.64,NA,15.64,,11.99,76.34,76.34,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,95333426,,Repair of mitral valve,A,,42.20,14.19,NA,14.19,,10.43,66.82,66.82,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00