You can only bill for the more extensive procedure which would be 33430. If your surgeon performed a complex valve repair first (in other words, he did more than just place a ring, he plicated the annulus or moved leaftlets before placing the ring), then I would add modifier 22 to 33430. My letter supporting the modifier would state that the physician had completed a complex valve repair prior to replacing the entire valve (I do this currently and always get paid for the modifier).
If, however, your surgeon only placed a ring and no reconstruction was required and then he realized the valve would need to be replaced, I would probably just bill 33430, no modifier.
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