Billing code 33545: Heart repairMedicare rate & RVUs in Washington
Reports surgical repair of a ventricular septal defect caused by myocardial infarction, with or without removal of damaged heart muscle.
CMS doesn’t publish an office rate for 33545 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 33545 covers
A cardiothoracic surgeon uses this code to repair a ventricular septal defect that developed as a complication of myocardial infarction. The operation may include removing infarcted myocardium as part of the repair. It is a major open-heart service generally performed in a hospital operating room, often when the defect causes significant shunting or hemodynamic instability. The operative report should identify the defect as postinfarction and describe the repair and any myocardial resection.
Report the code for the postinfarction defect repair, not for repair of a congenital septal defect or treatment of a ventricular aneurysm. The 90-day global period 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 other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this service. Assistant-at-surgery payment may be available; 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 33545 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $2,815.52 |
| Seattle (King Cnty) | Unavailable | $3,007.36 |
How the 33545 rate is calculated
Each of 33545’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 · 33545
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 55.63Practice expense 16.88Malpractice 13.36
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 33545
33545 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33545
Heart 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 · 33545
Heart 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
33545 without 51 · national facility
$2,868.14
Heart repair
33545-51 · Second procedure: 50%
$1,434.07
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%).
33545 compared with similar codes
Compare codes
33545 vs 33542 vs 33548 vs 33510: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 33542Heart lesion removal
- Use 33542 for excision of a ventricular aneurysm. Use 33545 for repair of a ventricular septal defect caused by myocardial infarction.
- 33548Ventricular restoration
- Use 33548 for a surgical ventricular restoration or remodeling procedure. It does not describe repair of a postinfarction ventricular septal defect.
- 33510Coronary bypass
- 33510 reports a single venous coronary bypass graft, not repair of a postinfarction septal defect. Both may be reported when both services are performed in the same operation.
33545 billing questions
How is this different from ventricular aneurysm surgery?
This code is for repair of a ventricular septal defect caused by myocardial infarction. Ventricular aneurysm excision or ventricular restoration addresses a different postinfarction heart problem.
Can CABG be reported during the same operation?
Yes, when coronary bypass grafting is separately performed, report the applicable CABG code based on the graft type and count. Same-session procedures are subject to the multiple-procedure payment rule.
What documentation supports this code?
The operative report should establish that the septal defect followed a myocardial infarction and describe its surgical repair. Document any myocardial resection performed as part of the operation.
Can modifier 50 be used?
No. The descriptor and anatomy make bilateral reporting with modifier 50 inappropriate.
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 major-surgery 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 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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