CPT code 33410: Aortic valve replacement, transventricular approach2026 Medicare rate & RVUs in Maryland
Reports open aortic valve replacement performed with cardiopulmonary bypass using a transventricular approach, rather than a standard valve-replacement route.
CMS doesn’t publish an office rate for 33410 in Maryland.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 33410 covers
This code identifies open replacement of the aortic valve using cardiopulmonary bypass and a transventricular approach. A cardiothoracic surgeon performs the operation in a hospital operating room, removing the diseased valve and implanting a replacement through the ventricular route described in the operative report. It is a distinct technique within the open aortic valve replacement family, not a general code for every surgical aortic valve replacement.
Select the code from the documented operative technique; the report should establish the transventricular approach and valve replacement. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this single aortic valve operation. Assistant-at-surgery payment may be allowed; 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 33410 pays more and less in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore area, MD | Unavailable | $2,533.48 |
| Rest of Maryland | Unavailable | $2,373.99 |
| Washington, DC area | Unavailable | $2,596.24 |
How the 33410 rate is calculated
Each of 33410’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 · 33410
RVUs × geographic indexes × conversion factor
Work45.25
45.25 RVUs× 1.000 GPCI
Practice expense14.84
14.84 RVUs× 1.000 GPCI
Malpractice11.28
11.28 RVUs× 1.000 GPCI
Adjusted RVUs
71.3700
Conversion factor
$33.4009
Medicare rate
$2,383.82
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33410
33410 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33410
Aortic valve replacement, transventricular approach
| 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 · 33410
Aortic valve replacement, transventricular approach
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
33410 without 51 · national facility
$2,383.82
Aortic valve replacement, transventricular approach
33410-51 · Second procedure: 50%
$1,191.91
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%).
33410 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 33405Aortic valve replacementStandard prosthetic valve
- Use 33410 when the operative report documents the transventricular approach. Code 33405 describes the standard open replacement approach.
- 33406Aortic valve replacementHomograft or stentless valve
- 33406 identifies replacement using a homograft or stentless valve. The transventricular approach is the defining distinction for 33410.
- 33411Aortic valve replacementTransventricular approach
- 33411 is for replacement with annular enlargement, such as a Konno procedure. Choose 33410 when the documented distinguishing technique is transventricular access.
- 33414Aortic valve repairNative valve reconstruction
- 33414 reports aortic valve repair, while 33410 reports replacement through a transventricular approach.
33410 billing questions
How does this differ from 33405?
33410 is for aortic valve replacement using a transventricular approach. Use 33405 for the standard open replacement technique when its descriptor fits the documented operation.
What documentation supports 33410?
The operative report should document aortic valve replacement, cardiopulmonary bypass, and the transventricular approach. A diagnosis of aortic valve disease alone does not establish the technique.
Can an assistant surgeon be reported?
CMS permits assistant-at-surgery payment for this code. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
Does modifier 50 apply?
No. Modifier 50 is inappropriate for this single aortic valve operation.
How does the multiple-procedure reduction work?
When other procedures are performed in the same session, the highest-valued procedure is paid in full and the other procedures are subject to the standard 50% reduction.
What is included in the global period?
The 90-day global period 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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