No office rate
33391 is for open aortic valvuloplasty for congenital stenosis; 33390 is the related code for other indications.
On this page
CMS RVU26D · Effective 2026-10-01
33391 Aortic valvuloplasty Medicare reimbursement rates in Wyoming
Reports open repair of congenital aortic valve stenosis on cardiopulmonary bypass when the surgeon reshapes the native valve rather than replacing it. Compare 33391 office and facility rates across CMS payment localities in Wyoming.
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 33391 in Wyoming?
Wyoming 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
$2034.96
1 of 1 localities have a supported rate.
Payment area: Wyoming**
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 33391: Open congenital aortic valve repair
Reports open repair of congenital aortic valve stenosis on cardiopulmonary bypass when the surgeon reshapes the native valve rather than replacing it.
A cardiothoracic surgeon opens the heart and operates on the native aortic valve using cardiopulmonary bypass to relieve congenital stenosis. The goal is to improve valve opening while retaining the patient’s own valve, rather than implanting a replacement. This major operation is generally performed in a hospital operating room; Medicare recorded facility services for the code in 2024 and no office services.
Choose this code when the operative report supports open aortic valvuloplasty for congenital stenosis with bypass. Documentation should identify the congenital valve problem, the open repair performed, and use of cardiopulmonary bypass. 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 paid at 50%. Modifier 50 is not appropriate for this single aortic valve operation. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation. CMS does not permit team surgery payment for this procedure.
CMS billing rules for 33391
- 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 RVU40.46 · 64%
- Practice expense (office) RVU13.28 · 21%
- Malpractice RVU9.71 · 15%
192
Medicare services in 2024 · #4356 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.
33391 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
92986 reports percutaneous balloon valvuloplasty. Report 33391 for open aortic valve repair performed with cardiopulmonary bypass.
No office rate
33391 preserves and repairs the native valve; 33405 is used when the surgeon replaces the aortic valve.
Compare 33391 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
Wyoming** →
Office / nonfacility
Unavailable
Facility
$2034.96
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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 33391 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
3,934
- Code
- 33391
- Physician work
- 40.46
- Practice expense
- 13.28
- Malpractice
- 9.71
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 40.46 | × 1.000 | 40.4600 |
| Practice expense | 13.28 | × 1.000 | 13.2800 |
| Malpractice | 9.71 | × 0.740 | 7.1854 |
| Total RVUs | 60.9254 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$2034.96
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 40.46 | 1 |
| Practice expense | 13.28 | 1 |
| Malpractice | 9.71 | 0.74 |
(40.46 × 1 + 13.28 × 1 + 9.71 × 0.74) × $33.4009 = $2034.96
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.
33391 billing questions
How is 33391 distinguished from 33390?
Use 33391 for open aortic valvuloplasty for congenital stenosis. Code 33390 is the related open aortic valvuloplasty code for other indications.
When is 92986 used instead?
92986 describes percutaneous balloon treatment of the aortic valve. This code is for open repair using cardiopulmonary bypass.
Does the global period include postoperative visits?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation.
Should modifier 50 be appended?
No. Modifier 50 is not appropriate for this single aortic valve operation.
How are other procedures paid when performed in the same session?
The highest-valued procedure is paid in full, and other procedures are paid at 50% under the standard multiple procedure reduction.
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.
3,93133369,,Replace aortic valve w/byp,A,,18.53,3.80,NA,3.80,,4.44,26.77,26.77,0,ZZZ,0.00,0.00,0.00,0,0,0,0,1,9,,33.4009,09,0,99,0.00,0.00,0.00
3,93233370,,Tcat plmt&rmvl cepd perq,A,,2.44,0.46,NA,0.46,,0.57,3.47,3.47,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,93333390,,Valvuloplasty aortic valve,A,,34.13,10.62,NA,10.62,,8.31,53.06,53.06,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,93433391,,Valvuloplasty aortic valve,A,,40.46,13.28,NA,13.28,,9.71,63.45,63.45,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,93533404,,Prepare heart-aorta conduit,A,,30.59,11.92,NA,11.92,,7.33,49.84,49.84,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,93633405,,Replacement aortic valve opn,A,,40.29,13.38,NA,13.38,,9.98,63.65,63.65,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,93733406,,Replacement aortic valve opn,A,,51.36,15.89,NA,15.89,,12.97,80.22,80.22,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,