CPT 33426: Mitral Valvuloplasty to Repair Mitral Valve
Medicare pays $2242 and commercial payers pay $2966 on average nationally for this procedure.
CPT code 33426 describes a mitral valvuloplasty procedure performed to repair the mitral valve so it closes properly and prevents backflow of blood from the left ventricle to the left atrium; this is a surgical valve repair service typically performed in an inpatient hospital or cardiac surgical suite under general anesthesia and involves direct repair of mitral valve leaflets and supporting structures to restore competent valve function.
For related coverage guidance, see recent payer policy updates: Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders, Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders, Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders.
Customize your policy alerts
Sign up for cpt 33426 policy alerts
Get alerted when payer policies referencing 33426 are released or updated.
Monitor payer policy activity
National Reimbursement Benchmarks
Average commercial reimbursement for CPT 33426 varies notably from Medicare. Medicare’s mean is $2,242.30 while BUCA’s mean (as a stand‑in for an average commercial group) is $2,965.70, so BUCA pays about $723.40 more on average than Medicare. That gap highlights higher commercial pricing for this procedure versus the federal program even though some commercial payers exceed BUCA’s mean by large margins.
Dispersion measured by the interquartile range (P75−P25) is widest for UnitedHealth Group at $2,634.60 (P75 $5,317.00 minus P25 $2,682.40) and Cigna is also wide at $2,492.60 (P75 $4,925.60 minus P25 $2,433.00). Blue Cross Blue Shield shows a moderate spread of $1,646.90, while Aetna is tighter at $1,226.90. BUCA’s IQR is $2,049.10 and Medicare’s IQR is $175.00, making Medicare the tightest and UnitedHealth Group the most dispersed payers in this set.