Billing code 33464: Tricuspid repairMedicare rate & RVUs in Washington
Reports surgical repair of the tricuspid valve performed with cardiopulmonary bypass, including repair for tricuspid regurgitation when the native valve is preserved.
CMS doesn’t publish an office rate for 33464 in Washington.
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 33464 covers
A cardiac surgeon uses this code for operative repair of the native tricuspid valve when cardiopulmonary bypass is used. The repair may address leaflet or annular problems that prevent proper valve closure, commonly in a patient with tricuspid regurgitation. It is an open cardiac surgical service performed in a hospital operating room; the repair may include annuloplasty, with or without a prosthetic ring, while preserving the native valve.
Select this code when the operative report supports tricuspid valvuloplasty and use of bypass; a replacement or a procedure performed without bypass belongs to a different code. Documentation should identify the valve treated, the repair performed, and bypass use. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of 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 multiple-procedure reduction. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and 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.
Where 33464 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $2,233.20 |
| Seattle (King Cnty) | Unavailable | $2,388.47 |
How the 33464 rate is calculated
Each of 33464’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 · 33464
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 43.50Practice expense 14.11Malpractice 10.43
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 33464
33464 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33464
Tricuspid 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 · 33464
Tricuspid 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
33464 without 51 · national facility
$2,272.60
Tricuspid repair
33464-51 · Second procedure: 50%
$1,136.30
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%).
33464 compared with similar codes
Compare codes
33464 vs 33463 vs 33465 vs 33460: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 33463Tricuspid repair
- Both describe tricuspid valve repair; choose 33464 when cardiopulmonary bypass is used and 33463 when it is not.
- 33465Valve replacement
- 33465 is for tricuspid valve replacement. Use 33464 when the surgeon repairs and preserves the native valve.
- 33460Tricuspid valve surgery
- 33460 describes tricuspid valvotomy, not valvuloplasty repair. Select based on the operation documented in the operative report.
33464 billing questions
How does this differ from 33463?
The distinguishing factor is cardiopulmonary bypass: this code is for tricuspid repair performed with bypass, while 33463 is the repair code for cases without bypass.
When should the tricuspid valve be coded as replaced instead?
Use 33465 when the native tricuspid valve is replaced rather than repaired. This code describes repair that preserves the native valve.
What documentation supports reporting this code?
The operative report should identify the tricuspid valve repair, describe the repair performed, and document cardiopulmonary bypass use.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can assistant or co-surgeon services be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
Does modifier 50 apply to this repair?
No. CMS identifies bilateral adjustment as inappropriate for this code because of its descriptor or anatomy.
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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