Billing code 33465: Valve replacementMedicare rate & RVUs in Washington
Reports open surgical replacement of a diseased tricuspid valve, typically during cardiopulmonary bypass when repair is not the operative treatment.
CMS doesn’t publish an office rate for 33465 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 33465 covers
A cardiothoracic surgeon removes the diseased tricuspid valve and replaces it with a prosthetic valve during open heart surgery with cardiopulmonary bypass. The operation may be performed for severe tricuspid valve disease, including stenosis or regurgitation, when the surgeon replaces rather than reconstructs the native valve. It is generally performed in a hospital operating room by a cardiac surgery team.
Report this code when the operative documentation supports tricuspid valve replacement, not a repair that preserves the native valve. The record should identify the valve treated and the replacement performed. This major surgery includes 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 others at 50%. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted. Modifier 50 is not appropriate for this single tricuspid valve operation.
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 33465 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $2,515.66 |
| Seattle (King Cnty) | Unavailable | $2,687.80 |
How the 33465 rate is calculated
Each of 33465’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 · 33465
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 49.45Practice expense 15.21Malpractice 12.10
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 33465
33465 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33465
Valve replacement
| 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 · 33465
Valve replacement
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
33465 without 51 · national facility
$2,563.85
Valve replacement
33465-51 · Second procedure: 50%
$1,281.93
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%).
33465 compared with similar codes
Compare codes
33465 vs 33463 vs 33464 vs 33468 vs 33430: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 33463Tricuspid repair
- Choose 33463 for tricuspid repair with ring insertion; choose 33465 when the surgeon replaces the valve.
- 33464Tricuspid repair
- Choose 33464 for tricuspid repair without ring insertion. Replacement of the tricuspid valve is reported with 33465.
- 33468Tricuspid valve surgery
- 33468 describes repair for Ebstein anomaly; 33465 is for replacement of the tricuspid valve.
- 33430Mitral valve replacement
- 33430 is replacement of the mitral valve. Use 33465 when the valve replaced is the tricuspid valve.
33465 billing questions
How is replacement distinguished from tricuspid valvuloplasty?
Use 33465 when the surgeon replaces the tricuspid valve. Codes 33463 and 33464 describe repair procedures that retain the native valve.
Does this code include the related postoperative visits?
Yes. Its 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?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.
What documentation supports reporting 33465?
The operative report should identify the tricuspid valve and document that it was replaced, rather than repaired with the native valve retained.
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
Fee sheets
Put 33465 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →