CPT code 33406: Aortic valve replacement, homograft or stentless valve2026 Medicare rate & RVUs in Nevada
Open replacement of a diseased aortic valve using a homograft or stentless valve, reported when the operative record supports that implant type.
In Nevada, Medicare pays $2,607.60 for 33406 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 33406 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 33406 covers
Code 33406 represents open aortic valve replacement performed with cardiopulmonary bypass using a homograft or stentless valve. A cardiac surgeon removes the diseased native valve and implants the selected replacement during major heart surgery, typically in a hospital operating room. The implanted valve type—not simply the diagnosis or the fact that the valve is biologic—distinguishes this service from other aortic valve replacement coding.
Report the code when the operative record supports open replacement, cardiopulmonary bypass, and use of a homograft or stentless valve. The procedure has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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. CMS may pay an assistant at surgery; co-surgeon payment requires supporting documentation, and team surgery payment is not permitted. Modifier 50 is inappropriate for this code.
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 Nevada compares for 33406
Across 109 of 109 payment localities, the facility rate for 33406 runs from $2,357.35 in Wisconsin to $3,377.14 in Alaska. Nevada pays $2,607.60. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Nevada · this page$2,607.60
- Los Angeles, CA · California$2,701.32+$93.72
- Washington, DC area · District of Columbia$2,915.48+$307.88
- Miami, FL · Florida$3,363.56+$755.96
- Chicago, IL · Illinois$3,255.09+$647.49
- Manhattan, NY · New York$3,129.05+$521.45
- Alaska · Alaska$3,377.14+$769.54
Other areas in Nevada first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $2,425.06 |
| ArkansasArkansas | — | $2,394.48 |
| ArizonaArizona | — | $2,600.59 |
| Bakersfield, CACalifornia | — | $2,593.58 |
| Chico, CACalifornia | — | $2,558.52 |
| El Centro, CACalifornia | — | $2,560.69 |
| Fresno, CACalifornia | — | $2,558.52 |
| Hanford, CACalifornia | — | $2,558.52 |
| Madera, CACalifornia | — | $2,558.52 |
| Merced, CACalifornia | — | $2,558.52 |
| Modesto, CACalifornia | — | $2,558.52 |
| Napa, CACalifornia | — | $2,743.13 |
| Oxnard, CACalifornia | — | $2,660.73 |
| Redding, CACalifornia | — | $2,558.52 |
| Rest of CaliforniaCalifornia | — | $2,558.52 |
| Riverside, CACalifornia | — | $2,697.57 |
| Sacramento, CACalifornia | — | $2,626.68 |
| Salinas, CACalifornia | — | $2,615.98 |
| San Diego, CACalifornia | — | $2,636.50 |
| Marin County, CACalifornia | — | $2,825.63 |
| San Francisco, CACalifornia | — | $2,810.90 |
| San Benito County, CACalifornia | — | $2,901.70 |
| Santa Clara County, CACalifornia | — | $2,841.48 |
| San Luis Obispo, CACalifornia | — | $2,581.35 |
| Santa Cruz, CACalifornia | — | $2,628.54 |
| Santa Maria, CACalifornia | — | $2,614.55 |
| Santa Rosa, CACalifornia | — | $2,650.88 |
| Stockton, CACalifornia | — | $2,558.52 |
| Vallejo, CACalifornia | — | $2,721.90 |
| Visalia, CACalifornia | — | $2,558.52 |
| Yuba City, CACalifornia | — | $2,558.52 |
| ColoradoColorado | — | $2,639.10 |
| ConnecticutConnecticut | — | $2,845.57 |
| DelawareDelaware | — | $2,637.87 |
| Fort Lauderdale, FLFlorida | — | $3,036.35 |
| Rest of FloridaFlorida | — | $2,873.97 |
| Atlanta, GAGeorgia | — | $2,780.13 |
| Rest of GeorgiaGeorgia | — | $2,705.28 |
| Hawaii, Guam, HIHawaii | — | $2,569.75 |
| IowaIowa | — | $2,373.08 |
| IdahoIdaho | — | $2,408.66 |
| East St. Louis, ILIllinois | — | $3,076.24 |
| Rest of IllinoisIllinois | — | $2,877.14 |
| Suburban Chicago, ILIllinois | — | $3,040.20 |
| IndianaIndiana | — | $2,418.01 |
| KansasKansas | — | $2,413.60 |
| KentuckyKentucky | — | $2,583.69 |
| New Orleans, LALouisiana | — | $2,707.02 |
| Rest of LouisianaLouisiana | — | $2,600.19 |
| Metropolitan Boston, MAMassachusetts | — | $2,805.07 |
| Rest of MassachusettsMassachusetts | — | $2,647.06 |
| Baltimore area, MDMaryland | — | $2,848.28 |
| Rest of MarylandMaryland | — | $2,667.42 |
| Rest of MaineMaine | — | $2,473.21 |
| Southern Maine, MEMaine | — | $2,514.79 |
| Detroit, MIMichigan | — | $2,958.03 |
| Rest of MichiganMichigan | — | $2,689.13 |
| MinnesotaMinnesota | — | $2,389.83 |
| Metropolitan Kansas City, MOMissouri | — | $2,637.08 |
| Metropolitan St. Louis, MOMissouri | — | $2,654.81 |
| Rest of MissouriMissouri | — | $2,594.91 |
| MississippiMississippi | — | $2,492.58 |
| MontanaMontana | — | $2,678.55 |
| North CarolinaNorth Carolina | — | $2,487.47 |
| North DakotaNorth Dakota | — | $2,422.09 |
| NebraskaNebraska | — | $2,369.10 |
| New HampshireNew Hampshire | — | $2,647.03 |
| Northern New JerseyNew Jersey | — | $2,901.87 |
| Rest of New JerseyNew Jersey | — | $2,838.89 |
| New MexicoNew Mexico | — | $2,722.44 |
| NYC suburbs and Long Island, NYNew York | — | $3,260.78 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $2,898.01 |
| Queens, NYNew York | — | $3,077.28 |
| Rest of New YorkNew York | — | $2,524.22 |
| OhioOhio | — | $2,636.71 |
| OklahomaOklahoma | — | $2,526.03 |
| Portland, OROregon | — | $2,654.88 |
| Rest of OregonOregon | — | $2,548.63 |
| Metropolitan Philadelphia, PAPennsylvania | — | $2,815.67 |
| Rest of PennsylvaniaPennsylvania | — | $2,612.07 |
| Puerto RicoPuerto Rico | — | $2,678.76 |
| Rhode IslandRhode Island | — | $2,682.74 |
| South CarolinaSouth Carolina | — | $2,574.10 |
| South DakotaSouth Dakota | — | $2,391.77 |
| TennesseeTennessee | — | $2,430.55 |
| Austin, TXTexas | — | $2,664.25 |
| Beaumont, TXTexas | — | $2,600.90 |
| Brazoria, TXTexas | — | $2,593.06 |
| Dallas, TXTexas | — | $2,631.22 |
| Fort Worth, TXTexas | — | $2,631.55 |
| Galveston, TXTexas | — | $2,614.92 |
| Houston, TXTexas | — | $2,852.32 |
| Rest of TexasTexas | — | $2,610.33 |
| UtahUtah | — | $2,603.39 |
| VirginiaVirginia | — | $2,543.03 |
| Virgin Islands, VIUnited States Virgin Islands | — | $2,678.76 |
| VermontVermont | — | $2,460.11 |
| Rest of WashingtonWashington | — | $2,626.31 |
| King County, WAWashington | — | $2,806.39 |
| WisconsinWisconsin | — | $2,357.35 |
| West VirginiaWest Virginia | — | $2,796.61 |
| WyomingWyoming | — | $2,566.79 |
33406 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 33406 rate is calculated
Each of 33406’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 · 33406
RVUs × geographic indexes × conversion factor
Work51.36
51.36 RVUs× 1.000 GPCI
Practice expense15.89
15.89 RVUs× 1.000 GPCI
Malpractice12.97
12.97 RVUs× 1.000 GPCI
Adjusted RVUs
80.2200
Conversion factor
$33.4009
Medicare rate
$2,679.42
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Nevada inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
3,937
- Code
- 33406
- Physician work
- 51.36
- Practice expense
- 15.89
- Malpractice
- 12.97
GPCI2026.csv
73
- Locality
- Nevada
- Physician work
- 1.000
- Practice expense
- 1.001
- Malpractice
- 0.833
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 51.36 | × 1.000 | 51.3600 |
| Practice expense | 15.89 | × 1.001 | 15.9059 |
| Malpractice | 12.97 | × 0.833 | 10.8040 |
| Total RVUs | 78.0699 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Nevada$2607.60
Facility: (51.36 × 1 + 15.89 × 1.001 + 12.97 × 0.833) × $33.4009 = $2607.60
Payment rules and modifiers for 33406
33406 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33406
Aortic valve replacement, homograft or stentless valve
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.84/0.07 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 33406
Aortic valve replacement, homograft or stentless valve
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
33406 without 51 · national facility
$2,679.42
Aortic valve replacement, homograft or stentless valve
33406-51 · Second procedure: 50%
$1,339.71
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 33406 has changed in Nevada
33406 · 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 | $2,607.60 | RVU26D |
| 2026-07-01 | Not available in this setting | $2,607.60 | RVU26C |
| 2026-04-01 | Not available in this setting | $2,607.60 | RVU26B |
| 2026-01-01 | Not available in this setting | $2,607.60 | RVU26A |
| 2025-10-01 | Not available in this setting | $2,685.33 | RVU25D |
| 2025-07-01 | Not available in this setting | $2,685.33 | RVU25C |
| 2025-04-01 | Not available in this setting | $2,685.33 | RVU25B |
| 2025-01-01 | Not available in this setting | $2,685.33 | RVU25A |
| 2024-10-01 | Not available in this setting | $2,755.35 | RVU24D |
| 2024-07-01 | Not available in this setting | $2,755.35 | RVU24C |
| 2024-04-01 | Not available in this setting | $2,755.35 | RVU24B |
| 2024-03-09 | Not available in this setting | $2,755.35 | RVU24AR |
| 2024-01-01 | Not available in this setting | $2,710.37 | RVU24A |
| 2023-10-01 | Not available in this setting | $2,904.87 | RVU23D |
| 2023-07-01 | Not available in this setting | $2,904.87 | RVU23C |
| 2023-04-01 | Not available in this setting | $2,904.87 | RVU23B |
| 2023-01-01 | Not available in this setting | $2,904.87 | RVU23A |
| 2022-10-01 | Not available in this setting | $3,077.87 | RVU22D |
| 2022-07-01 | Not available in this setting | $3,077.87 | RVU22C |
| 2022-04-01 | Not available in this setting | $3,077.87 | RVU22B |
| 2022-01-01 | Not available in this setting | $3,077.87 | RVU22A |
| 2021-10-01 | Not available in this setting | $3,090.98 | RVU21D |
| 2021-07-01 | Not available in this setting | $3,090.98 | RVU21C |
| 2021-04-01 | Not available in this setting | $3,090.98 | RVU21B |
| 2021-01-01 | Not available in this setting | $3,090.98 | RVU21A |
| 2020-10-01 | Not available in this setting | $3,076.27 | RVU20D |
| 2020-07-01 | Not available in this setting | $3,076.27 | RVU20C |
| 2020-04-01 | Not available in this setting | $3,076.27 | RVU20B |
| 2020-01-01 | Not available in this setting | $3,076.27 | RVU20A |
| 2019-10-01 | Not available in this setting | $2,974.55 | RVU19D |
| 2019-07-01 | Not available in this setting | $2,974.55 | RVU19C |
| 2019-04-01 | Not available in this setting | $2,974.55 | RVU19B |
| 2019-01-01 | Not available in this setting | $2,974.55 | RVU19A |
| 2018-10-01 | Not available in this setting | $2,966.45 | RVU18D |
| 2018-07-01 | Not available in this setting | $2,966.45 | RVU18C |
| 2018-04-01 | Not available in this setting | $2,966.45 | RVU18B |
| 2018-01-01 | Not available in this setting | $2,966.45 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $3,005.65 | RVU17D |
| 2017-07-01 | Not available in this setting | $3,005.65 | RVU17C |
| 2017-04-01 | Not available in this setting | $3,005.65 | RVU17B |
| 2017-01-01 | Not available in this setting | $3,005.65 | RVU17A |
| 2016-10-01 | Not available in this setting | $3,034.98 | RVU16D |
| 2016-07-01 | Not available in this setting | $3,034.98 | RVU16C |
| 2016-04-01 | Not available in this setting | $3,034.98 | RVU16B |
| 2016-01-01 | Not available in this setting | $3,034.98 | RVU16A |
| 2015-10-01 | Not available in this setting | $3,041.88 | RVU15D |
| 2015-07-01 | Not available in this setting | $3,041.88 | RVU15C |
| 2015-04-01 | Not available in this setting | $3,026.74 | RVU15B |
| 2015-01-01 | Not available in this setting | $3,026.74 | RVU15A |
| 2014-10-01 | Not available in this setting | $3,095.83 | RVU14D |
| 2014-07-01 | Not available in this setting | $3,095.83 | RVU14C |
| 2014-04-01 | Not available in this setting | $3,095.83 | RVU14B |
| 2014-01-01 | Not available in this setting | $3,095.83 | RVU14A |
| 2013-10-01 | Not available in this setting | $3,089.29 | RVU13D |
| 2013-07-01 | Not available in this setting | Rate data unavailable | RVU13C |
| 2013-04-01 | Not available in this setting | Rate data unavailable | RVU13B |
| 2013-01-01 | Not available in this setting | Rate data unavailable | RVU13AR |
Where the Nevada rate applies
Nevada is a Medicare payment area, not a city. Our Census mapping connects it to 138 cities and communities in Nevada. Some span more than one payment area; confirm with the service ZIP.
- Alamo
- Amargosa Valley
- Austin
- Baker
- Battle Mountain
- Beatty
- Beaverdam
- Bennett Springs
33406 billing questions
How is 33406 different from 33405?
33406 applies when the operative record identifies a homograft or stentless valve. Code 33405 is for a prosthetic valve other than those types.
Is cardiopulmonary bypass included?
Yes. The code describes open aortic valve replacement performed with cardiopulmonary bypass.
Can another procedure be reported during the same operation?
A separately reportable procedure may be subject to the standard multiple procedure reduction when performed in the same session. The operative documentation must support each reported service.
Which modifiers or surgical assistance rules should the biller consider?
Modifier 50 is inappropriate. CMS may pay an assistant at surgery, while co-surgeon payment requires supporting documentation; team surgery payment is not permitted.
What care is included in the global period?
The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.
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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