CPT code 33361: TAVR, percutaneous femoral approach2026 Medicare rate & RVUs in Maryland
Reports transcatheter replacement of the aortic valve when the prosthesis is delivered through percutaneous femoral arterial access.
CMS doesn’t publish an office rate for 33361 in Maryland.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 33361 covers
Code 33361 reports transcatheter aortic valve replacement for a patient whose prosthetic valve is delivered through percutaneous femoral arterial access. The procedure treats aortic valve disease such as aortic stenosis. An interventional cardiologist and cardiac surgeon commonly perform the procedure together in a hospital catheterization laboratory or hybrid operating room. The operative record should identify the valve replacement and show that the femoral artery was accessed percutaneously rather than exposed surgically or approached through another route.
Select 33361 based on the access route, not simply because a TAVR occurred. Document the approach and any conversion to a different access method. Medicare assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons are permitted, and team-surgery payment requires supporting documentation.
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.
Where 33361 pays more and less in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore area, MD | Unavailable | $1,145.06 |
| Rest of Maryland | Unavailable | $1,074.15 |
| Washington, DC area | Unavailable | $1,169.11 |
How the 33361 rate is calculated
Each of 33361’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 33361
RVUs × geographic indexes × conversion factor
Work21.91
21.91 RVUs× 1.000 GPCI
Practice expense5.14
5.14 RVUs× 1.000 GPCI
Malpractice5.26
5.26 RVUs× 1.000 GPCI
Adjusted RVUs
32.3100
Conversion factor
$33.4009
Medicare rate
$1,079.18
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33361
The CMS indicators that decide how 33361 is paid alongside other services.
CMS payment indicators · 33361
TAVR, percutaneous femoral approach
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 2 | Permitted. |
| Team surgery (66) | 1 | Permitted with supporting documentation. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
33361 without 51 · national facility
$1,079.18
TAVR, percutaneous femoral approach
33361-51 · Second procedure: 50%
$539.59
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
33361 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 33362Aortic valve replacementTranscatheter, open femoral access
- Both describe transfemoral TAVR, but 33361 uses percutaneous femoral access; 33362 applies when the femoral artery is surgically exposed.
- 33363TAVROpen axillary access
- 33363 describes TAVR through open axillary or subclavian access, rather than the percutaneous femoral route used for 33361.
- 33365Aortic valve replacementTransapical approach
- 33365 is for a transapical TAVR approach. Use 33361 when the prosthesis is delivered through percutaneous femoral arterial access.
- 33367TAVR bypass supportWith cardiopulmonary bypass
- 33367 describes TAVR with cardiopulmonary bypass using percutaneous femoral access; 33361 identifies the percutaneous femoral approach without that bypass distinction.
33361 billing questions
How does 33361 differ from 33362?
33361 is for percutaneous femoral access. Use 33362 when the femoral artery is surgically exposed for the TAVR.
Can 33361 be reported with another TAVR access code for the same valve?
Choose the code that matches the access route used for the valve replacement. Do not report a second TAVR access code for the same implantation.
Is modifier 50 appropriate for 33361?
No. CMS identifies bilateral adjustment as inappropriate for this code and anatomy.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons are permitted, while team-surgery payment requires supporting documentation.
What does the 0-day global period include?
Same-day preoperative and postoperative care is included in the procedure's global period.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
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