Billing code 33692: Tetralogy repairMedicare rate & RVUs in Washington
Reports definitive surgical correction of tetralogy of Fallot when pulmonary atresia is absent, based on the documented anatomy and repair performed.
CMS doesn’t publish an office rate for 33692 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 33692 covers
Code 33692 describes definitive open correction of tetralogy of Fallot without pulmonary atresia. A congenital cardiac surgeon typically performs the operation in a hospital operating room using cardiopulmonary bypass. The repair addresses the ventricular septal defect and obstruction to blood flow from the right ventricle to the pulmonary artery; operative techniques vary with the patient’s anatomy and may include septal patch closure and relief of outflow obstruction.
Select the code from the documented diagnosis and operative details, including whether pulmonary atresia or pulmonary artery reconstruction is present. The operative report should identify the anatomy and the corrective work performed. This major operation has a 90-day global period that includes the day-before preoperative visit and related postoperative care through day 90. 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. Modifier 50 is inappropriate. 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 33692 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $1,770.97 |
| Seattle (King Cnty) | Unavailable | $1,889.36 |
How the 33692 rate is calculated
Each of 33692’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 · 33692
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 35.25Practice expense 10.01Malpractice 8.90
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 33692
33692 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33692
Tetralogy 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 · 33692
Tetralogy 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
33692 without 51 · national facility
$1,808.99
Tetralogy repair
33692-51 · Second procedure: 50%
$904.50
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%).
33692 compared with similar codes
Compare codes
33692 vs 33694 vs 33697 vs 33681 vs 33690: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 33694Tetralogy repair
- Both describe complete tetralogy repair without pulmonary atresia. Distinguish them by whether pulmonary artery reconstruction specified for 33694 is part of the operation.
- 33697Tetralogy repair
- Use 33697 for complete tetralogy repair when pulmonary atresia is present; 33692 is for cases without pulmonary atresia.
- 33681VSD closure
- Code 33681 describes closure of a single VSD. Code 33692 is for complete correction of tetralogy of Fallot, including its associated outflow obstruction.
- 33690Pulmonary artery banding
- Code 33690 describes pulmonary artery banding, a staged palliative operation; 33692 describes definitive tetralogy correction.
33692 billing questions
How does 33692 differ from 33694?
Code 33692 describes complete repair without pulmonary atresia. Use 33694 when the documented repair includes pulmonary artery reconstruction as specified by that code.
Can 33692 be used when pulmonary atresia is present?
No. Code 33692 is for tetralogy of Fallot without pulmonary atresia; code 33697 is the related repair code for tetralogy with pulmonary atresia.
Is an isolated VSD closure reported as 33692?
No. Code 33692 represents complete correction of tetralogy of Fallot, not closure of an isolated ventricular septal defect. Code 33681 describes closure of a single VSD.
Does modifier 50 apply to this repair?
No. CMS identifies bilateral adjustment as inappropriate for this code; do not append modifier 50 to represent bilateral surgery.
What services are included in the global period?
The 90-day global period includes the day-before preoperative visit and related postoperative care through 90 days after surgery.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation, and team surgery 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 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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