CPT code 33411: Aortic valve replacement, transventricular approach2026 Medicare rate & RVUs in Guam
Reports open aortic valve replacement performed through a transventricular approach, typically by a cardiac surgeon during hospital-based cardiac surgery.
CMS doesn’t publish an office rate for 33411 in Guam.
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 33411 covers
This code describes surgical replacement of the aortic valve through a transventricular approach, with cardiopulmonary bypass. A cardiac surgeon performs the operation in a hospital operating room, removing the diseased valve and implanting a replacement. The operative report should identify the approach and the valve replacement; the procedure is distinct from aortic valve repair and from other aortic valve replacement techniques.
Report the code when the documented operation matches this approach, rather than selecting it solely because an aortic valve was replaced. Record the operative details that support the approach and any additional anatomic work, and compare the applicable sibling code when enlargement is documented. The service 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. Assistant-at-surgery services may be paid; CMS does not permit co-surgeon or team-surgery payment 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.
33411 in Hawaii, Guam, HI
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam, HI | Unavailable | $2,989.37 |
How the 33411 rate is calculated
Each of 33411’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 · 33411
RVUs × geographic indexes × conversion factor
Work60.52
60.52 RVUs× 1.000 GPCI
Practice expense17.88
17.88 RVUs× 1.000 GPCI
Malpractice14.94
14.94 RVUs× 1.000 GPCI
Adjusted RVUs
93.3400
Conversion factor
$33.4009
Medicare rate
$3,117.64
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33411
33411 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33411
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) | 0 | Not permitted. |
| 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 · 33411
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
33411 without 51 · national facility
$3,117.64
Aortic valve replacement, transventricular approach
33411-51 · Second procedure: 50%
$1,558.82
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%).
33411 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 33405Aortic valve replacementStandard prosthetic valve
- Use 33411 when the operative report supports the transventricular approach. Code 33405 describes a different open aortic valve replacement technique.
- 33412Aortic valve replacementCoronary ostia translocation
- Both are aortic valve replacement codes, but the operative details distinguish the sibling codes. Check the report for the approach and any additional anatomic work before choosing.
- 33414Aortic valve repairNative valve reconstruction
- 33411 is for replacing the aortic valve; 33414 is for repairing it while retaining the native valve.
33411 billing questions
How is this code distinguished from a routine open aortic valve replacement?
The operative report must support the transventricular approach. Do not select this code based only on the fact that the surgeon replaced the aortic valve.
How does this differ from aortic valve repair?
This code represents replacement of the valve. A procedure that repairs the native aortic valve rather than replacing it belongs to the repair code family.
What documentation supports reporting this code?
The operative report should identify the aortic valve replacement, the transventricular approach, and any associated enlargement or other anatomic work that may affect code selection.
Can an assistant surgeon be reported?
Assistant-at-surgery payment may be available for this code. CMS does not permit co-surgeon or team-surgery payment.
What care is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
What happens when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures 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
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