No office rate
Both describe tricuspid valve repair; choose 33464 when cardiopulmonary bypass is used and 33463 when it is not.
On this page
CMS RVU26D · Effective 2026-10-01
33464 Tricuspid repair Medicare reimbursement rates in Wisconsin
Reports surgical repair of the tricuspid valve performed with cardiopulmonary bypass, including repair for tricuspid regurgitation when the native valve is preserved. Compare 33464 office and facility rates across CMS payment localities in Wisconsin.
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 33464 in Wisconsin?
Wisconsin has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$2011.73
1 of 1 localities have a supported rate.
Payment area: Wisconsin
One mapped payment locality.
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 33464: Tricuspid valve repair with bypass
Reports surgical repair of the tricuspid valve performed with cardiopulmonary bypass, including repair for tricuspid regurgitation when the native valve is preserved.
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.
CMS billing rules for 33464
- 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
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU43.50 · 64%
- Practice expense (office) RVU14.11 · 21%
- Malpractice RVU10.43 · 15%
3.3K
Medicare services in 2024 · #2116 by national volume
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.
33464 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
No office rate
33465 is for tricuspid valve replacement. Use 33464 when the surgeon repairs and preserves the native valve.
No office rate
33460 describes tricuspid valvotomy, not valvuloplasty repair. Select based on the operation documented in the operative report.
Compare 33464 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.
1 of 1 payment localities
Wisconsin →
Office / nonfacility
Unavailable
Facility
$2011.73
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 33464 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
3,963
- Code
- 33464
- Physician work
- 43.50
- Practice expense
- 14.11
- Malpractice
- 10.43
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 43.50 | × 1.000 | 43.5000 |
| Practice expense | 14.11 | × 0.958 | 13.5174 |
| Malpractice | 10.43 | × 0.308 | 3.2124 |
| Total RVUs | 60.2298 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wisconsin$2011.73
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 43.5 | 1 |
| Practice expense | 14.11 | 0.958 |
| Malpractice | 10.43 | 0.308 |
(43.5 × 1 + 14.11 × 0.958 + 10.43 × 0.308) × $33.4009 = $2011.73
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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 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.
3,9603345F,,Mammo assess hghlymalig doc,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
3,96133460,,Revision of tricuspid valve,A,,43.58,13.15,NA,13.15,,10.46,67.19,67.19,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,96233463,,Valvuloplasty tricuspid,A,,55.65,16.58,NA,16.58,,13.56,85.79,85.79,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,96333464,,Valvuloplasty tricuspid,A,,43.50,14.11,NA,14.11,,10.43,68.04,68.04,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,96433465,,Replace tricuspid valve,A,,49.45,15.21,NA,15.21,,12.10,76.76,76.76,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,96533468,,Revision of tricuspid valve,A,,44.00,12.89,NA,12.89,,11.12,68.01,68.01,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,96633474,,Revision of pulmonary valve,A,,38.42,12.88,NA,12.88,,9.71,61.01,61.01,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,