CPT code 33405: Aortic valve replacement, standard prosthetic valve2026 Medicare rate & RVUs

Medicare pays $2,125.97 for 33405 nationally in a facility.

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

What 33405 covers

A cardiac surgeon removes the diseased aortic valve and implants a prosthesis during open surgery, typically using cardiopulmonary bypass. Common indications include severe aortic stenosis or regurgitation requiring surgical replacement. The implanted valve may be mechanical or a stented tissue prosthesis; this code distinguishes those options from a homograft or stentless tissue valve. These operations are performed in a hospital operating room, and CMS recorded 18,664 facility services for the code in 2024.

Report the code when the operative record supports open aortic valve replacement and identifies the implanted prosthesis sufficiently to distinguish it from the valve types represented by neighboring codes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

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 33405 pays more and less

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

109 of 109 payment localities

33405 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 33405 rate is calculated

Each of 33405’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 33405

33405 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

33405 compared with similar codes

How to choose

33406Aortic valve replacementHomograft or stentless valve

Choose 33406 when the replacement uses a homograft. Code 33405 represents a conventional prosthesis, such as a mechanical or stented tissue valve.

33410Aortic valve replacementTransventricular approach

Choose 33410 when a stentless tissue valve is implanted; 33405 is for a prosthesis other than a homograft or stentless tissue valve.

33411Aortic valve replacementTransventricular approach

33411 describes aortic valve replacement with annular enlargement. Use 33405 when the operation does not include that enlargement procedure.

33414Aortic valve repairNative valve reconstruction

33414 is for repair of the aortic valve. Use 33405 when the surgeon removes the diseased valve and implants a prosthesis.

Codes related to 33405

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