No office rate
Choose 33463 for tricuspid repair with ring insertion; choose 33465 when the surgeon replaces the valve.
On this page
CMS RVU26D · Effective 2026-10-01
33465 Valve replacement Medicare reimbursement rates in Wyoming
Reports open surgical replacement of a diseased tricuspid valve, typically during cardiopulmonary bypass when repair is not the operative treatment. Compare 33465 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 33465 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
$2458.77
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 33465: Open tricuspid valve replacement
Reports open surgical replacement of a diseased tricuspid valve, typically during cardiopulmonary bypass when repair is not the operative treatment.
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.
CMS billing rules for 33465
- 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 RVU49.45 · 64%
- Practice expense (office) RVU15.21 · 20%
- Malpractice RVU12.10 · 16%
576
Medicare services in 2024 · #3435 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.
33465 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
Choose 33464 for tricuspid repair without ring insertion. Replacement of the tricuspid valve is reported with 33465.
No office rate
33468 describes repair for Ebstein anomaly; 33465 is for replacement of the tricuspid valve.
No office rate
33430 is replacement of the mitral valve. Use 33465 when the valve replaced is the tricuspid valve.
Compare 33465 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
$2458.77
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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 33465 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
3,964
- Code
- 33465
- Physician work
- 49.45
- Practice expense
- 15.21
- Malpractice
- 12.10
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 49.45 | × 1.000 | 49.4500 |
| Practice expense | 15.21 | × 1.000 | 15.2100 |
| Malpractice | 12.10 | × 0.740 | 8.9540 |
| Total RVUs | 73.6140 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$2458.77
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 49.45 | 1 |
| Practice expense | 15.21 | 1 |
| Malpractice | 12.1 | 0.74 |
(49.45 × 1 + 15.21 × 1 + 12.1 × 0.74) × $33.4009 = $2458.77
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.
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 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.
3,96133460,,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
3,96733475,,Replacement pulmonary valve,A,,41.34,13.19,NA,13.19,,9.80,64.33,64.33,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,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.,,,,,,