CPT code 33365: Aortic valve replacement, transapical approach2026 Medicare rate & RVUs in Connecticut
Reports transcatheter aortic valve replacement delivered through the heart’s apex when the documented access route is transapical.
In Connecticut, Medicare pays $1,350.89 for 33365 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 33365 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
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.
How Connecticut compares for 33365
Across 109 of 109 payment localities, the facility rate for 33365 runs from $1,120.76 in Wisconsin to $1,626.00 in Alaska. Connecticut pays $1,350.89. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Connecticut · this page$1,350.89
- Los Angeles, CA · California$1,275.58−$75.31
- Washington, DC area · District of Columbia$1,380.03+$29.14
- Miami, FL · Florida$1,603.10+$252.21
- Chicago, IL · Illinois$1,552.94+$202.05
- Manhattan, NY · New York$1,484.73+$133.84
- Alaska · Alaska$1,626.00+$275.11
Other areas in Connecticut first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $1,158.41 |
| ArkansasArkansas | — | $1,144.54 |
| ArizonaArizona | — | $1,237.89 |
| Bakersfield, CACalifornia | — | $1,227.73 |
| Chico, CACalifornia | — | $1,210.69 |
| El Centro, CACalifornia | — | $1,211.74 |
| Fresno, CACalifornia | — | $1,210.69 |
| Hanford, CACalifornia | — | $1,210.69 |
| Madera, CACalifornia | — | $1,210.69 |
| Merced, CACalifornia | — | $1,210.69 |
| Modesto, CACalifornia | — | $1,210.69 |
| Napa, CACalifornia | — | $1,288.70 |
| Oxnard, CACalifornia | — | $1,255.53 |
| Redding, CACalifornia | — | $1,210.69 |
| Rest of CaliforniaCalifornia | — | $1,210.69 |
| Riverside, CACalifornia | — | $1,278.05 |
| Sacramento, CACalifornia | — | $1,240.44 |
| Salinas, CACalifornia | — | $1,235.31 |
| San Diego, CACalifornia | — | $1,243.04 |
| Marin County, CACalifornia | — | $1,324.39 |
| San Francisco, CACalifornia | — | $1,317.26 |
| San Benito County, CACalifornia | — | $1,359.88 |
| Santa Clara County, CACalifornia | — | $1,330.72 |
| San Luis Obispo, CACalifornia | — | $1,219.22 |
| Santa Cruz, CACalifornia | — | $1,237.76 |
| Santa Maria, CACalifornia | — | $1,234.10 |
| Santa Rosa, CACalifornia | — | $1,248.13 |
| Stockton, CACalifornia | — | $1,210.69 |
| Vallejo, CACalifornia | — | $1,278.42 |
| Visalia, CACalifornia | — | $1,210.69 |
| Yuba City, CACalifornia | — | $1,210.69 |
| ColoradoColorado | — | $1,251.40 |
| DelawareDelaware | — | $1,255.01 |
| Fort Lauderdale, FLFlorida | — | $1,446.31 |
| Rest of FloridaFlorida | — | $1,371.02 |
| Atlanta, GAGeorgia | — | $1,322.18 |
| Rest of GeorgiaGeorgia | — | $1,293.09 |
| Hawaii, Guam, HIHawaii | — | $1,213.12 |
| IowaIowa | — | $1,130.90 |
| IdahoIdaho | — | $1,147.83 |
| East St. Louis, ILIllinois | — | $1,471.07 |
| Rest of IllinoisIllinois | — | $1,375.08 |
| Suburban Chicago, ILIllinois | — | $1,447.60 |
| IndianaIndiana | — | $1,151.95 |
| KansasKansas | — | $1,151.16 |
| KentuckyKentucky | — | $1,234.39 |
| New Orleans, LALouisiana | — | $1,291.07 |
| Rest of LouisianaLouisiana | — | $1,242.62 |
| Metropolitan Boston, MAMassachusetts | — | $1,325.17 |
| Rest of MassachusettsMassachusetts | — | $1,256.04 |
| Baltimore area, MDMaryland | — | $1,352.30 |
| Rest of MarylandMaryland | — | $1,268.09 |
| Rest of MaineMaine | — | $1,179.08 |
| Southern Maine, MEMaine | — | $1,195.06 |
| Detroit, MIMichigan | — | $1,411.19 |
| Rest of MichiganMichigan | — | $1,284.04 |
| MinnesotaMinnesota | — | $1,132.33 |
| Metropolitan Kansas City, MOMissouri | — | $1,257.32 |
| Metropolitan St. Louis, MOMissouri | — | $1,265.14 |
| Rest of MissouriMissouri | — | $1,241.41 |
| MississippiMississippi | — | $1,191.92 |
| MontanaMontana | — | $1,273.82 |
| North CarolinaNorth Carolina | — | $1,185.23 |
| North DakotaNorth Dakota | — | $1,149.65 |
| NebraskaNebraska | — | $1,128.50 |
| New HampshireNew Hampshire | — | $1,256.16 |
| Northern New JerseyNew Jersey | — | $1,374.82 |
| Rest of New JerseyNew Jersey | — | $1,347.49 |
| New MexicoNew Mexico | — | $1,299.94 |
| NevadaNevada | — | $1,239.41 |
| NYC suburbs and Long Island, NYNew York | — | $1,546.93 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $1,376.12 |
| Queens, NYNew York | — | $1,458.50 |
| Rest of New YorkNew York | — | $1,202.03 |
| OhioOhio | — | $1,258.66 |
| OklahomaOklahoma | — | $1,206.24 |
| Portland, OROregon | — | $1,256.43 |
| Rest of OregonOregon | — | $1,211.15 |
| Metropolitan Philadelphia, PAPennsylvania | — | $1,338.45 |
| Rest of PennsylvaniaPennsylvania | — | $1,246.44 |
| Puerto RicoPuerto Rico | — | $1,273.28 |
| Rhode IslandRhode Island | — | $1,274.59 |
| South CarolinaSouth Carolina | — | $1,227.70 |
| South DakotaSouth Dakota | — | $1,134.97 |
| TennesseeTennessee | — | $1,159.07 |
| Austin, TXTexas | — | $1,263.57 |
| Beaumont, TXTexas | — | $1,241.50 |
| Brazoria, TXTexas | — | $1,233.24 |
| Dallas, TXTexas | — | $1,251.46 |
| Fort Worth, TXTexas | — | $1,252.20 |
| Galveston, TXTexas | — | $1,243.71 |
| Houston, TXTexas | — | $1,358.65 |
| Rest of TexasTexas | — | $1,243.78 |
| UtahUtah | — | $1,240.94 |
| VirginiaVirginia | — | $1,209.20 |
| Virgin Islands, VIUnited States Virgin Islands | — | $1,273.28 |
| VermontVermont | — | $1,168.64 |
| Rest of WashingtonWashington | — | $1,245.89 |
| King County, WAWashington | — | $1,324.20 |
| WisconsinWisconsin | — | $1,120.76 |
| West VirginiaWest Virginia | — | $1,338.66 |
| WyomingWyoming | — | $1,219.71 |
33365 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
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.
How the rate is built · 33365
RVUs × geographic indexes × conversion factor
Work25.93
25.93 RVUs× 1.000 GPCI
Practice expense5.94
5.94 RVUs× 1.000 GPCI
Malpractice6.28
6.28 RVUs× 1.000 GPCI
Adjusted RVUs
38.1500
Conversion factor
$33.4009
Medicare rate
$1,274.24
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Connecticut inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
3,927
- Code
- 33365
- Physician work
- 25.93
- Practice expense
- 5.94
- Malpractice
- 6.28
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 25.93 | × 1.020 | 26.4486 |
| Practice expense | 5.94 | × 1.077 | 6.3974 |
| Malpractice | 6.28 | × 1.210 | 7.5988 |
| Total RVUs | 40.4448 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Connecticut$1350.89
Facility: (25.93 × 1.02 + 5.94 × 1.077 + 6.28 × 1.21) × $33.4009 = $1350.89
Payment rules and modifiers for 33365
The CMS indicators that decide how 33365 is paid alongside other services.
CMS payment indicators · 33365
Aortic valve replacement, transapical 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
33365 without 51 · national facility
$1,274.24
Aortic valve replacement, transapical approach
33365-51 · Second procedure: 50%
$637.12
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%).
How 33365 has changed in Connecticut
33365 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $1,350.89 | RVU26D |
| 2026-07-01 | Not available in this setting | $1,350.89 | RVU26C |
| 2026-04-01 | Not available in this setting | $1,350.89 | RVU26B |
| 2026-01-01 | Not available in this setting | $1,350.89 | RVU26A |
| 2025-10-01 | Not available in this setting | $1,438.85 | RVU25D |
| 2025-07-01 | Not available in this setting | $1,438.85 | RVU25C |
| 2025-04-01 | Not available in this setting | $1,438.85 | RVU25B |
| 2025-01-01 | Not available in this setting | $1,438.85 | RVU25A |
| 2024-10-01 | Not available in this setting | $1,478.25 | RVU24D |
| 2024-07-01 | Not available in this setting | $1,478.25 | RVU24C |
| 2024-04-01 | Not available in this setting | $1,478.25 | RVU24B |
| 2024-03-09 | Not available in this setting | $1,478.25 | RVU24AR |
| 2024-01-01 | Not available in this setting | $1,454.12 | RVU24A |
| 2023-10-01 | Not available in this setting | $1,483.60 | RVU23D |
| 2023-07-01 | Not available in this setting | $1,483.60 | RVU23C |
| 2023-04-01 | Not available in this setting | $1,483.60 | RVU23B |
| 2023-01-01 | Not available in this setting | $1,483.60 | RVU23A |
| 2022-10-01 | Not available in this setting | $1,504.47 | RVU22D |
| 2022-07-01 | Not available in this setting | $1,504.47 | RVU22C |
| 2022-04-01 | Not available in this setting | $1,504.47 | RVU22B |
| 2022-01-01 | Not available in this setting | $1,504.47 | RVU22A |
| 2021-10-01 | Not available in this setting | $1,509.00 | RVU21D |
| 2021-07-01 | Not available in this setting | $1,509.00 | RVU21C |
| 2021-04-01 | Not available in this setting | $1,509.00 | RVU21B |
| 2021-01-01 | Not available in this setting | $1,509.00 | RVU21A |
| 2020-10-01 | Not available in this setting | $1,601.56 | RVU20D |
| 2020-07-01 | Not available in this setting | $1,601.56 | RVU20C |
| 2020-04-01 | Not available in this setting | $1,601.56 | RVU20B |
| 2020-01-01 | Not available in this setting | $1,601.56 | RVU20A |
| 2019-10-01 | Not available in this setting | $2,008.48 | RVU19D |
| 2019-07-01 | Not available in this setting | $2,008.48 | RVU19C |
| 2019-04-01 | Not available in this setting | $2,008.48 | RVU19B |
| 2019-01-01 | Not available in this setting | $2,008.48 | RVU19A |
| 2018-10-01 | Not available in this setting | $2,002.86 | RVU18D |
| 2018-07-01 | Not available in this setting | $2,002.86 | RVU18C |
| 2018-04-01 | Not available in this setting | $2,002.86 | RVU18B |
| 2018-01-01 | Not available in this setting | $2,002.86 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $2,002.79 | RVU17D |
| 2017-07-01 | Not available in this setting | $2,002.79 | RVU17C |
| 2017-04-01 | Not available in this setting | $2,002.79 | RVU17B |
| 2017-01-01 | Not available in this setting | $2,002.79 | RVU17A |
| 2016-10-01 | Not available in this setting | $1,996.66 | RVU16D |
| 2016-07-01 | Not available in this setting | $1,996.66 | RVU16C |
| 2016-04-01 | Not available in this setting | $1,996.66 | RVU16B |
| 2016-01-01 | Not available in this setting | $1,996.66 | RVU16A |
| 2015-10-01 | Not available in this setting | $2,001.65 | RVU15D |
| 2015-07-01 | Not available in this setting | $2,001.65 | RVU15C |
| 2015-04-01 | Not available in this setting | $1,991.69 | RVU15B |
| 2015-01-01 | Not available in this setting | $1,991.69 | RVU15A |
| 2014-10-01 | Not available in this setting | $1,980.17 | RVU14D |
| 2014-07-01 | Not available in this setting | $1,980.17 | RVU14C |
| 2014-04-01 | Not available in this setting | $1,980.17 | RVU14B |
| 2014-01-01 | Not available in this setting | $1,980.17 | RVU14A |
| 2013-10-01 | Not available in this setting | $1,921.02 | RVU13D |
| 2013-07-01 | Not available in this setting | $1,921.02 | RVU13C |
| 2013-04-01 | Not available in this setting | $1,921.02 | RVU13B |
| 2013-01-01 | Not available in this setting | $1,921.02 | RVU13AR |
Where the Connecticut rate applies
Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.
- Ansonia
- Ball Pond
- Baltic
- Bantam
- Bethel
- Bethlehem Village
- Bigelow Corners
- Blue Hills
33365 billing questions
How does 33365 differ from 33361?
33365 identifies transapical delivery through the heart’s apex. 33361 is for transcatheter valve delivery through a percutaneous femoral artery approach.
Is this code for conventional open aortic valve replacement?
No. It describes catheter-based valve replacement using transapical access, not direct surgical replacement of the valve.
What documentation supports 33365?
The operative report should identify the transapical access route and document transcatheter prosthetic valve deployment. Document other procedures performed in the same session separately as applicable.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons are permitted; team-surgery payment requires supporting documentation.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the procedure’s 0-day global period.
Can modifier 50 be used?
No. The aortic-valve procedure and its anatomy make a bilateral adjustment inappropriate.
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
Show the CMS file lines behind this rate
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