The Society of Thoracic Surgeons explained it this way, if the surgeon does nothing but place a ring, then that would be a simple mitral valve repair (33426). If ANY reconstruction is done (ie: partial resection of P1 or P2, plication of the annulus and/or reapproximation of the valve leaflets), then you would bill 33427.
I can't tell from what you wrote below if this was simple or complex. I would need to see more of the note if you still need help.
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