CPT code 33366: TAVR, transapical approach2026 Medicare rate & RVUs in South Dakota

Reports aortic valve replacement using a catheter-delivered prosthesis introduced through the heart’s apex rather than a peripheral artery.

CMS RVU26DEffective Oct 1, 2026One payment locality79 Medicare services in 2024

In South Dakota, Medicare pays $1,248.36 for 33366 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$1,248.36Hospital or facility

Check a contract rate as a % of Medicare · 33366 nationwide

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

We’ll open 33366 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in South Dakota
  2. What 33366 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 33366 covers

This code represents transcatheter aortic valve replacement performed through a surgical opening at the heart’s apex. A cardiothoracic surgeon, often working with an interventional cardiologist as part of a heart team, introduces the prosthetic valve through the left ventricular apex and advances it across the native aortic valve. The procedure is typically performed in a hospital operating room or hybrid suite for a patient who needs aortic valve replacement and whose planned access route is transapical.

Select the code from the documented access route: transapical access distinguishes this service from peripheral arterial and transaortic approaches. The operative report should support valve implantation and identify the route; report a bypass-specific family code when cardiopulmonary bypass is used. This procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires medical-necessity documentation; 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.

How South Dakota compares for 33366

Across 109 of 109 payment localities, the facility rate for 33366 runs from $1,232.89 in Wisconsin to $1,789.59 in Alaska. South Dakota pays $1,248.36. The RVUs are the same everywhere; the geographic indexes change the dollars.

33366 in South Dakota vs other payment areas
  1. South Dakota · this page$1,248.36
  2. Los Angeles, CA · California$1,402.13+$153.77
  3. Washington, DC area · District of Columbia$1,516.36+$268.00
  4. Miami, FL · Florida$1,759.67+$511.31
  5. Chicago, IL · Illinois$1,704.99+$456.63
  6. Manhattan, NY · New York$1,630.85+$382.49
  7. Alaska · Alaska$1,789.59+$541.23

Other areas in South Dakota first, then benchmark localities. Bars start at $0.

Every other payment area

33366 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$1,274.13
ArkansasArkansas—$1,259.00
ArizonaArizona—$1,360.83
Bakersfield, CACalifornia—$1,349.75
Chico, CACalifornia—$1,331.12
El Centro, CACalifornia—$1,332.26
Fresno, CACalifornia—$1,331.12
Hanford, CACalifornia—$1,331.12

33366 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
33366 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

See 33366 in every payment locality

How the 33366 rate is calculated

Each of 33366’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 · 33366

RVUs × geographic indexes × conversion factor

Office or facility?

Work28.62

28.62 RVUs× 1.000 GPCI

Practice expense6.45

6.45 RVUs× 1.000 GPCI

Malpractice6.86

6.86 RVUs× 1.000 GPCI

Adjusted RVUs

41.9300

Conversion factor

$33.4009

Medicare rate

$1,400.50

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact South Dakota inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,928

Code
33366
Physician work
28.62
Practice expense
6.45
Malpractice
6.86

GPCI2026.csv

94

Locality
South Dakota
Physician work
1.000
Practice expense
1.000
Malpractice
0.336
Facility calculation for 33366 in South Dakota
ComponentRVULocality factorAdjusted
Physician work28.62× 1.00028.6200
Practice expense6.45× 1.0006.4500
Malpractice6.86× 0.3362.3050
Total RVUs37.3750
Conversion factor× 33.4009

Facility rate, South Dakota$1248.36

Facility: (28.62 × 1 + 6.45 × 1 + 6.86 × 0.336) × $33.4009 = $1248.36

Open 33366 in the RVU calculator

Payment rules and modifiers for 33366

The CMS indicators that decide how 33366 is paid alongside other services.

CMS payment indicators · 33366

TAVR, transapical approach

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)2Permitted.
Team surgery (66)1Permitted with supporting documentation.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

33366 without 51 · national facility

$1,400.50

TAVR, transapical approach

33366-51 · Second procedure: 50%

$700.25

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%).

When to use modifier 51

How 33366 has changed in South Dakota

33366 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

Base rate by release · bars start at $0 · select a bar to compare

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
  1. January 1, 2014

    RVU14A

    No ratechanged toNo rate

    Held through RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D, RVU19A, RVU19B, RVU19C, RVU19D, RVU20A, RVU20B, RVU20C, RVU20D, RVU21A, RVU21B, RVU21C, RVU21D, RVU22A, RVU22B, RVU22C, RVU22D, RVU23A, RVU23B, RVU23C, RVU23D, RVU24A, RVU24AR, RVU24B, RVU24C, RVU24D, RVU25A, RVU25B, RVU25C, RVU25D, RVU26A, RVU26B, RVU26C, RVU26D.

  2. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$1,248.36RVU26D
2026-07-01Not available in this setting$1,248.36RVU26C
2026-04-01Not available in this setting$1,248.36RVU26B
2026-01-01Not available in this setting$1,248.36RVU26A
2025-10-01Not available in this setting$1,356.16RVU25D
2025-07-01Not available in this setting$1,356.16RVU25C
2025-04-01Not available in this setting$1,356.16RVU25B
2025-01-01Not available in this setting$1,356.16RVU25A
2024-10-01Not available in this setting$1,389.09RVU24D
2024-07-01Not available in this setting$1,389.09RVU24C
2024-04-01Not available in this setting$1,389.09RVU24B
2024-03-09Not available in this setting$1,389.09RVU24AR
2024-01-01Not available in this setting$1,366.41RVU24A
2023-10-01Not available in this setting$1,411.70RVU23D
2023-07-01Not available in this setting$1,411.70RVU23C
2023-04-01Not available in this setting$1,411.70RVU23B
2023-01-01Not available in this setting$1,411.70RVU23A
2022-10-01Not available in this setting$1,442.04RVU22D
2022-07-01Not available in this setting$1,442.04RVU22C
2022-04-01Not available in this setting$1,442.04RVU22B
2022-01-01Not available in this setting$1,442.04RVU22A
2021-10-01Not available in this setting$1,450.76RVU21D
2021-07-01Not available in this setting$1,450.76RVU21C
2021-04-01Not available in this setting$1,450.76RVU21B
2021-01-01Not available in this setting$1,450.76RVU21A
2020-10-01Not available in this setting$1,499.02RVU20D
2020-07-01Not available in this setting$1,499.02RVU20C
2020-04-01Not available in this setting$1,499.02RVU20B
2020-01-01Not available in this setting$1,499.02RVU20A
2019-10-01Not available in this setting$1,834.52RVU19D
2019-07-01Not available in this setting$1,834.52RVU19C
2019-04-01Not available in this setting$1,834.52RVU19B
2019-01-01Not available in this setting$1,834.52RVU19A
2018-10-01Not available in this setting$1,832.91RVU18D
2018-07-01Not available in this setting$1,832.91RVU18C
2018-04-01Not available in this setting$1,832.91RVU18B
2018-01-01Not available in this setting$1,832.91RVU18AR1
2017-10-01Not available in this setting$1,833.07RVU17D
2017-07-01Not available in this setting$1,833.07RVU17C
2017-04-01Not available in this setting$1,833.07RVU17B
2017-01-01Not available in this setting$1,833.07RVU17A
2016-10-01Not available in this setting$1,828.53RVU16D
2016-07-01Not available in this setting$1,828.53RVU16C
2016-04-01Not available in this setting$1,828.53RVU16B
2016-01-01Not available in this setting$1,828.53RVU16A
2015-10-01Not available in this setting$1,835.56RVU15D
2015-07-01Not available in this setting$1,835.56RVU15C
2015-04-01Not available in this setting$1,826.42RVU15B
2015-01-01Not available in this setting$1,826.42RVU15A
2014-10-01Not available in this setting$1,823.21RVU14D
2014-07-01Not available in this setting$1,823.21RVU14C
2014-04-01Not available in this setting$1,823.21RVU14B
2014-01-01Not available in this setting$1,823.21RVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 33366 for an earlier date of service

Where the South Dakota rate applies

South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Agar
  • Agency Village
  • Akaska
  • Albee
  • Alcester
  • Alexandria
  • Allen

Browse all communities in South Dakota

33366 billing questions

When should 33366 be selected instead of another TAVR code?

Use 33366 when the prosthetic valve is delivered through transapical access at the heart’s apex. The documented route, rather than the diagnosis alone, distinguishes it from other TAVR approach codes.

How does 33366 differ from a bypass-specific TAVR code?

33366 identifies the transapical approach without the bypass-specific designation. If cardiopulmonary bypass is used, select the applicable bypass code for the documented approach.

Can modifier 50 be reported?

No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate for the procedure.

Is same-day postoperative care included?

Yes. The 0-day global period includes same-day preoperative and postoperative care.

When is assistant-at-surgery payment allowed?

Payment for an assistant at surgery requires documentation that the assistant was medically necessary. Co-surgeons are permitted, while team-surgery payment requires supporting documentation.

How are other procedures in the same session paid?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures performed in that session are paid at 50%.

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
RVUs for 33366PPRRVU2026_Oct_nonQPP.csv, line 3,928 (RVU26D)
Geographic factors for South DakotaGPCI2026.csv, line 94 (RVU26D)

Open CMS sourceHow we calculate rates

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