CPT code 33365: Aortic valve replacement, transapical approach2026 Medicare rate & RVUs in California

CMS doesn’t publish an office rate for 33365 in California.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 33365 covers

This service replaces the aortic valve with a catheter-delivered prosthesis introduced through the apex of the heart, typically using a surgical chest approach. A cardiac surgeon and interventional cardiology team may perform the procedure in a hospital hybrid operating room or catheterization suite. The transapical route is distinct from delivery through a peripheral artery and from conventional open valve replacement, in which the surgeon directly replaces the valve.

Report this code when the operative documentation supports transapical access and transcatheter valve deployment. Record the access route, valve procedure, and any additional procedures performed during the session. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Assistant-at-surgery payment requires documented medical necessity; co-surgeons are permitted, and team-surgery payment requires supporting documentation. Modifier 50 is inappropriate for this procedure.

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 33365 pays more and less in California

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

29 of 29 payment localities

How the 33365 rate is calculated

Each of 33365’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.

Payment rules and modifiers for 33365

The CMS indicators that decide how 33365 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

33365 compared with similar codes

How to choose

33361TAVRPercutaneous femoral approach

Use 33365 for transapical delivery through the heart’s apex; use 33361 when the catheter is introduced percutaneously through a femoral artery.

33362Aortic valve replacementTranscatheter, open femoral access

33362 identifies TAVR through an open femoral artery approach. The transapical route through the heart’s apex is reported with 33365.

33366TAVRTransapical approach

33366 is the sibling code for a different TAVR access route. Select between these codes based on the route documented in the operative report.

33405Aortic valve replacementStandard prosthetic valve

33365 describes catheter-based valve replacement using transapical access; 33405 is conventional surgical replacement of the aortic valve.

Codes related to 33365

Related codes aren’t interchangeable: bill the code that matches the service performed.

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

Open CMS sourceHow we calculate rates