CPT code 33776: Atrial switch repair, with VSD closure2026 Medicare rate & RVUs in Washington, DC area
Reports transposition of the great arteries repair using an atrial baffle, with closure of a ventricular septal defect during the operation.
In Washington, DC area, Medicare pays $2,020.11 for 33776 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 33776 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 33776 covers
This code describes an atrial-switch repair for transposition of the great arteries that includes closing a ventricular septal defect (VSD). The operation redirects systemic and pulmonary venous blood at the atrial level with a baffle and closes the VSD as part of the repair. Congenital cardiac surgeons typically perform it in an operating room, often for a patient with complex congenital heart disease.
Report the code when the operative record supports both the atrial baffle repair and VSD closure. The closure is part of this combined service. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures at 50%. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment may be available; 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.
How Washington, DC area compares for 33776
Across 109 of 109 payment localities, the facility rate for 33776 runs from $1,633.96 in Wisconsin to $2,315.44 in Alaska. Washington, DC area pays $2,020.11. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Washington, DC area · this page$2,020.11
- Los Angeles, CA · California$1,879.34−$140.77
- Miami, FL · Florida$2,304.12+$284.01
- Chicago, IL · Illinois$2,229.65+$209.54
- Manhattan, NY · New York$2,159.59+$139.48
- Alaska · Alaska$2,315.44+$295.33
- Alabama · Alabama$1,671.73−$348.38
Other areas in District of Columbia first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| ArkansasArkansas | — | $1,650.25 |
| ArizonaArizona | — | $1,795.21 |
| Bakersfield, CACalifornia | — | $1,801.11 |
| Chico, CACalifornia | — | $1,778.00 |
| El Centro, CACalifornia | — | $1,779.42 |
| Fresno, CACalifornia | — | $1,778.00 |
| Hanford, CACalifornia | — | $1,778.00 |
| Madera, CACalifornia | — | $1,778.00 |
| Merced, CACalifornia | — | $1,778.00 |
| Modesto, CACalifornia | — | $1,778.00 |
| Napa, CACalifornia | — | $1,918.08 |
| Oxnard, CACalifornia | — | $1,852.49 |
| Redding, CACalifornia | — | $1,778.00 |
| Rest of CaliforniaCalifornia | — | $1,778.00 |
| Riverside, CACalifornia | — | $1,869.66 |
| Sacramento, CACalifornia | — | $1,828.48 |
| Salinas, CACalifornia | — | $1,821.09 |
| San Diego, CACalifornia | — | $1,837.67 |
| Marin County, CACalifornia | — | $1,980.09 |
| San Francisco, CACalifornia | — | $1,970.38 |
| San Benito County, CACalifornia | — | $2,032.90 |
| Santa Clara County, CACalifornia | — | $1,993.20 |
| San Luis Obispo, CACalifornia | — | $1,796.59 |
| Santa Cruz, CACalifornia | — | $1,833.99 |
| Santa Maria, CACalifornia | — | $1,820.72 |
| Santa Rosa, CACalifornia | — | $1,849.80 |
| Stockton, CACalifornia | — | $1,778.00 |
| Vallejo, CACalifornia | — | $1,904.08 |
| Visalia, CACalifornia | — | $1,778.00 |
| Yuba City, CACalifornia | — | $1,778.00 |
| ColoradoColorado | — | $1,828.46 |
| ConnecticutConnecticut | — | $1,965.65 |
| DelawareDelaware | — | $1,821.37 |
| Fort Lauderdale, FLFlorida | — | $2,086.11 |
| Rest of FloridaFlorida | — | $1,974.36 |
| Atlanta, GAGeorgia | — | $1,917.46 |
| Rest of GeorgiaGeorgia | — | $1,857.86 |
| Hawaii, Guam, HIHawaii | — | $1,788.77 |
| IowaIowa | — | $1,640.77 |
| IdahoIdaho | — | $1,664.64 |
| East St. Louis, ILIllinois | — | $2,104.71 |
| Rest of IllinoisIllinois | — | $1,972.89 |
| Suburban Chicago, ILIllinois | — | $2,089.81 |
| IndianaIndiana | — | $1,671.38 |
| KansasKansas | — | $1,666.57 |
| KentuckyKentucky | — | $1,777.46 |
| New Orleans, LALouisiana | — | $1,863.06 |
| Rest of LouisianaLouisiana | — | $1,788.01 |
| Metropolitan Boston, MAMassachusetts | — | $1,948.64 |
| Rest of MassachusettsMassachusetts | — | $1,832.80 |
| Baltimore area, MDMaryland | — | $1,967.11 |
| Rest of MarylandMaryland | — | $1,842.83 |
| Rest of MaineMaine | — | $1,707.19 |
| Southern Maine, MEMaine | — | $1,740.47 |
| Detroit, MIMichigan | — | $2,030.51 |
| Rest of MichiganMichigan | — | $1,848.95 |
| MinnesotaMinnesota | — | $1,661.24 |
| Metropolitan Kansas City, MOMissouri | — | $1,816.79 |
| Metropolitan St. Louis, MOMissouri | — | $1,829.55 |
| Rest of MissouriMissouri | — | $1,782.63 |
| MississippiMississippi | — | $1,715.08 |
| MontanaMontana | — | $1,849.17 |
| North CarolinaNorth Carolina | — | $1,717.67 |
| North DakotaNorth Dakota | — | $1,680.11 |
| NebraskaNebraska | — | $1,638.81 |
| New HampshireNew Hampshire | — | $1,831.78 |
| Northern New JerseyNew Jersey | — | $2,009.66 |
| Rest of New JerseyNew Jersey | — | $1,962.50 |
| New MexicoNew Mexico | — | $1,871.24 |
| NevadaNevada | — | $1,802.48 |
| NYC suburbs and Long Island, NYNew York | — | $2,248.66 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $2,001.73 |
| Queens, NYNew York | — | $2,127.11 |
| Rest of New YorkNew York | — | $1,743.30 |
| OhioOhio | — | $1,814.40 |
| OklahomaOklahoma | — | $1,739.78 |
| Portland, OROregon | — | $1,842.75 |
| Rest of OregonOregon | — | $1,763.20 |
| Metropolitan Philadelphia, PAPennsylvania | — | $1,942.96 |
| Rest of PennsylvaniaPennsylvania | — | $1,798.57 |
| Puerto RicoPuerto Rico | — | $1,850.22 |
| Rhode IslandRhode Island | — | $1,854.67 |
| South CarolinaSouth Carolina | — | $1,774.03 |
| South DakotaSouth Dakota | — | $1,660.12 |
| TennesseeTennessee | — | $1,678.16 |
| Austin, TXTexas | — | $1,844.54 |
| Beaumont, TXTexas | — | $1,790.54 |
| Brazoria, TXTexas | — | $1,792.07 |
| Dallas, TXTexas | — | $1,817.64 |
| Fort Worth, TXTexas | — | $1,817.03 |
| Galveston, TXTexas | — | $1,806.65 |
| Houston, TXTexas | — | $1,963.14 |
| Rest of TexasTexas | — | $1,799.98 |
| UtahUtah | — | $1,794.66 |
| VirginiaVirginia | — | $1,758.43 |
| Virgin Islands, VIUnited States Virgin Islands | — | $1,850.22 |
| VermontVermont | — | $1,704.34 |
| Rest of WashingtonWashington | — | $1,819.12 |
| King County, WAWashington | — | $1,952.25 |
| WisconsinWisconsin | — | $1,633.96 |
| West VirginiaWest Virginia | — | $1,916.16 |
| WyomingWyoming | — | $1,775.49 |
33776 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 33776 rate is calculated
Each of 33776’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 · 33776
RVUs × geographic indexes × conversion factor
Work33.88
33.88 RVUs× 1.000 GPCI
Practice expense12.95
12.95 RVUs× 1.000 GPCI
Malpractice8.55
8.55 RVUs× 1.000 GPCI
Adjusted RVUs
55.3800
Conversion factor
$33.4009
Medicare rate
$1,849.74
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Washington, DC area inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
4,064
- Code
- 33776
- Physician work
- 33.88
- Practice expense
- 12.95
- Malpractice
- 8.55
GPCI2026.csv
39
- Locality
- Washington, DC area
- Physician work
- 1.054
- Practice expense
- 1.178
- Malpractice
- 1.113
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 33.88 | × 1.054 | 35.7095 |
| Practice expense | 12.95 | × 1.178 | 15.2551 |
| Malpractice | 8.55 | × 1.113 | 9.5162 |
| Total RVUs | 60.4808 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Washington, DC area$2020.11
Facility: (33.88 × 1.054 + 12.95 × 1.178 + 8.55 × 1.113) × $33.4009 = $2020.11
Payment rules and modifiers for 33776
33776 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33776
Atrial switch repair, with VSD closure
| 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 · 33776
Atrial switch repair, with VSD closure
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
33776 without 51 · national facility
$1,849.74
Atrial switch repair, with VSD closure
33776-51 · Second procedure: 50%
$924.87
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 33776 has changed in Washington, DC area
33776 · 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 | $2,020.11 | RVU26D |
| 2026-07-01 | Not available in this setting | $2,020.11 | RVU26C |
| 2026-04-01 | Not available in this setting | $2,020.11 | RVU26B |
| 2026-01-01 | Not available in this setting | $2,020.11 | RVU26A |
| 2025-10-01 | Not available in this setting | $2,081.44 | RVU25D |
| 2025-07-01 | Not available in this setting | $2,081.44 | RVU25C |
| 2025-04-01 | Not available in this setting | $2,081.44 | RVU25B |
| 2025-01-01 | Not available in this setting | $2,081.44 | RVU25A |
| 2024-10-01 | Not available in this setting | $2,134.76 | RVU24D |
| 2024-07-01 | Not available in this setting | $2,134.76 | RVU24C |
| 2024-04-01 | Not available in this setting | $2,134.76 | RVU24B |
| 2024-03-09 | Not available in this setting | $2,134.76 | RVU24AR |
| 2024-01-01 | Not available in this setting | $2,099.92 | RVU24A |
| 2023-10-01 | Not available in this setting | $2,188.37 | RVU23D |
| 2023-07-01 | Not available in this setting | $2,188.37 | RVU23C |
| 2023-04-01 | Not available in this setting | $2,188.37 | RVU23B |
| 2023-01-01 | Not available in this setting | $2,188.37 | RVU23A |
| 2022-10-01 | Not available in this setting | $2,259.29 | RVU22D |
| 2022-07-01 | Not available in this setting | $2,259.29 | RVU22C |
| 2022-04-01 | Not available in this setting | $2,259.29 | RVU22B |
| 2022-01-01 | Not available in this setting | $2,259.29 | RVU22A |
| 2021-10-01 | Not available in this setting | $2,266.24 | RVU21D |
| 2021-07-01 | Not available in this setting | $2,266.24 | RVU21C |
| 2021-04-01 | Not available in this setting | $2,266.24 | RVU21B |
| 2021-01-01 | Not available in this setting | $2,266.24 | RVU21A |
| 2020-10-01 | Not available in this setting | $2,299.27 | RVU20D |
| 2020-07-01 | Not available in this setting | $2,299.27 | RVU20C |
| 2020-04-01 | Not available in this setting | $2,299.27 | RVU20B |
| 2020-01-01 | Not available in this setting | $2,299.27 | RVU20A |
| 2019-10-01 | Not available in this setting | $2,287.32 | RVU19D |
| 2019-07-01 | Not available in this setting | $2,287.32 | RVU19C |
| 2019-04-01 | Not available in this setting | $2,199.15 | RVU19B |
| 2019-01-01 | Not available in this setting | $2,199.15 | RVU19A |
| 2018-10-01 | Not available in this setting | $2,284.17 | RVU18D |
| 2018-07-01 | Not available in this setting | $2,284.17 | RVU18C |
| 2018-04-01 | Not available in this setting | $2,284.17 | RVU18B |
| 2018-01-01 | Not available in this setting | $2,284.17 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $2,416.26 | RVU17D |
| 2017-07-01 | Not available in this setting | $2,416.26 | RVU17C |
| 2017-04-01 | Not available in this setting | $2,416.26 | RVU17B |
| 2017-01-01 | Not available in this setting | $2,416.26 | RVU17A |
| 2016-10-01 | Not available in this setting | $2,419.33 | RVU16D |
| 2016-07-01 | Not available in this setting | $2,419.33 | RVU16C |
| 2016-04-01 | Not available in this setting | $2,419.33 | RVU16B |
| 2016-01-01 | Not available in this setting | $2,419.33 | RVU16A |
| 2015-10-01 | Not available in this setting | $2,436.48 | RVU15D |
| 2015-07-01 | Not available in this setting | $2,154.99 | RVU15C |
| 2015-04-01 | Not available in this setting | $2,144.26 | RVU15B |
| 2015-01-01 | Not available in this setting | $2,144.26 | RVU15A |
| 2014-10-01 | Not available in this setting | $2,273.36 | RVU14D |
| 2014-07-01 | Not available in this setting | $2,273.36 | RVU14C |
| 2014-04-01 | Not available in this setting | $2,273.36 | RVU14B |
| 2014-01-01 | Not available in this setting | $2,273.36 | RVU14A |
| 2013-10-01 | Not available in this setting | $2,312.82 | RVU13D |
| 2013-07-01 | Not available in this setting | $2,312.82 | RVU13C |
| 2013-04-01 | Not available in this setting | $2,312.82 | RVU13B |
| 2013-01-01 | Not available in this setting | $2,312.82 | RVU13AR |
Where the Washington, DC area rate applies
Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.
- Washington
33776 billing questions
How does this differ from 33774?
Both involve an atrial baffle repair for transposition. Use 33776 when the operation also includes VSD closure; 33774 describes the atrial baffle procedure without that specified addition.
Is VSD closure separately reported with 33776?
VSD closure is included in this combined procedure. The operative report should document the closure as part of the atrial-switch repair.
How does 33776 differ from 33777?
33776 includes VSD closure. 33777 identifies an atrial baffle repair that includes repair of subpulmonary obstruction.
Can modifier 50 be appended?
No. The anatomy and procedure represented by 33776 make modifier 50 inappropriate.
What global period applies?
Medicare assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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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