CPT code 33840: Coarctation repair, direct anastomosis2026 Medicare rate & RVUs in South Carolina

Reports surgical removal of a narrowed aortic segment followed by direct reconnection of the aortic ends to repair coarctation.

CMS RVU26DEffective Oct 1, 2026One payment locality

In South Carolina, Medicare pays $1,135.21 for 33840 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$1,135.21Hospital or facility

Check a contract rate as a % of Medicare · 33840 nationwide

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

We’ll open 33840 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in South Carolina
  2. What 33840 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 33840 covers

The surgeon removes the narrowed segment of the aorta and reconnects the remaining ends directly, creating an end-to-end anastomosis. This operation treats aortic coarctation, usually a congenital narrowing, and is typically performed by a congenital cardiac or cardiothoracic surgeon in a hospital operating room. Patients are often infants or children, though coarctation may be repaired later in life.

Choose this code when the operative report supports excision of the coarctation and direct anastomosis, rather than reconstruction with an interposition graft or patch. 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 others are subject to the standard 50% reduction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation. Team surgery is not permitted, and modifier 50 is inappropriate for this anatomy.

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 South Carolina compares for 33840

Across 109 of 109 payment localities, the facility rate for 33840 runs from $1,051.26 in Wisconsin to $1,475.02 in Alaska. South Carolina pays $1,135.21. The RVUs are the same everywhere; the geographic indexes change the dollars.

33840 in South Carolina vs other payment areas
  1. South Carolina · this page$1,135.21
  2. Los Angeles, CA · California$1,212.96+$77.75
  3. Washington, DC area · District of Columbia$1,298.86+$163.65
  4. Miami, FL · Florida$1,465.44+$330.23
  5. Chicago, IL · Illinois$1,418.06+$282.85
  6. Manhattan, NY · New York$1,383.38+$248.17
  7. Alaska · Alaska$1,475.02+$339.81

Other areas in South Carolina first, then benchmark localities. Bars start at $0.

Every other payment area

33840 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$1,070.13
ArkansasArkansas—$1,056.17
ArizonaArizona—$1,150.46
Bakersfield, CACalifornia—$1,160.60
Chico, CACalifornia—$1,146.46
El Centro, CACalifornia—$1,147.33
Fresno, CACalifornia—$1,146.46
Hanford, CACalifornia—$1,146.46

33840 rates by state

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

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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
33840 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

See 33840 in every payment locality

How the 33840 rate is calculated

Each of 33840’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 · 33840

RVUs × geographic indexes × conversion factor

Office or facility?

Work20.81

20.81 RVUs× 1.000 GPCI

Practice expense9.45

9.45 RVUs× 1.000 GPCI

Malpractice5.23

5.23 RVUs× 1.000 GPCI

Adjusted RVUs

35.4900

Conversion factor

$33.4009

Medicare rate

$1,185.40

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact South Carolina inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,084

Code
33840
Physician work
20.81
Practice expense
9.45
Malpractice
5.23

GPCI2026.csv

93

Locality
South Carolina
Physician work
1.000
Practice expense
0.924
Malpractice
0.850
Facility calculation for 33840 in South Carolina
ComponentRVULocality factorAdjusted
Physician work20.81× 1.00020.8100
Practice expense9.45× 0.9248.7318
Malpractice5.23× 0.8504.4455
Total RVUs33.9873
Conversion factor× 33.4009

Facility rate, South Carolina$1135.21

Facility: (20.81 × 1 + 9.45 × 0.924 + 5.23 × 0.85) × $33.4009 = $1135.21

Open 33840 in the RVU calculator

Payment rules and modifiers for 33840

33840 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 33840

Coarctation repair, direct anastomosis

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.84/0.07Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 33840

Coarctation repair, direct anastomosis

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

33840 without 51 · national facility

$1,185.40

Coarctation repair, direct anastomosis

33840-51 · Second procedure: 50%

$592.70

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%).

When to use modifier 51

How 33840 has changed in South Carolina

33840 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

Base rate by release · bars start at $0 · select a bar to compare

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
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$1,135.21RVU26D
2026-07-01Not available in this setting$1,135.21RVU26C
2026-04-01Not available in this setting$1,135.21RVU26B
2026-01-01Not available in this setting$1,135.21RVU26A
2025-10-01Not available in this setting$1,133.59RVU25D
2025-07-01Not available in this setting$1,133.59RVU25C
2025-04-01Not available in this setting$1,133.59RVU25B
2025-01-01Not available in this setting$1,133.59RVU25A
2024-10-01Not available in this setting$1,161.27RVU24D
2024-07-01Not available in this setting$1,161.27RVU24C
2024-04-01Not available in this setting$1,161.27RVU24B
2024-03-09Not available in this setting$1,161.27RVU24AR
2024-01-01Not available in this setting$1,142.32RVU24A
2023-10-01Not available in this setting$1,164.38RVU23D
2023-07-01Not available in this setting$1,164.38RVU23C
2023-04-01Not available in this setting$1,164.38RVU23B
2023-01-01Not available in this setting$1,164.38RVU23A
2022-10-01Not available in this setting$1,174.56RVU22D
2022-07-01Not available in this setting$1,174.56RVU22C
2022-04-01Not available in this setting$1,174.56RVU22B
2022-01-01Not available in this setting$1,174.56RVU22A
2021-10-01Not available in this setting$1,179.55RVU21D
2021-07-01Not available in this setting$1,179.55RVU21C
2021-04-01Not available in this setting$1,179.55RVU21B
2021-01-01Not available in this setting$1,179.55RVU21A
2020-10-01Not available in this setting$1,194.59RVU20D
2020-07-01Not available in this setting$1,194.59RVU20C
2020-04-01Not available in this setting$1,194.59RVU20B
2020-01-01Not available in this setting$1,194.59RVU20A
2019-10-01Not available in this setting$1,183.35RVU19D
2019-07-01Not available in this setting$1,183.35RVU19C
2019-04-01Not available in this setting$1,183.35RVU19B
2019-01-01Not available in this setting$1,183.35RVU19A
2018-10-01Not available in this setting$1,183.02RVU18D
2018-07-01Not available in this setting$1,183.02RVU18C
2018-04-01Not available in this setting$1,183.02RVU18B
2018-01-01Not available in this setting$1,183.02RVU18AR1
2017-10-01Not available in this setting$1,250.07RVU17D
2017-07-01Not available in this setting$1,250.07RVU17C
2017-04-01Not available in this setting$1,250.07RVU17B
2017-01-01Not available in this setting$1,250.07RVU17A
2016-10-01Not available in this setting$1,215.03RVU16D
2016-07-01Not available in this setting$1,215.03RVU16C
2016-04-01Not available in this setting$1,215.03RVU16B
2016-01-01Not available in this setting$1,215.03RVU16A
2015-10-01Not available in this setting$1,269.54RVU15D
2015-07-01Not available in this setting$1,173.45RVU15C
2015-04-01Not available in this setting$1,167.61RVU15B
2015-01-01Not available in this setting$1,167.61RVU15A
2014-10-01Not available in this setting$1,245.05RVU14D
2014-07-01Not available in this setting$1,245.05RVU14C
2014-04-01Not available in this setting$1,245.05RVU14B
2014-01-01Not available in this setting$1,245.05RVU14A
2013-10-01Not available in this setting$1,154.54RVU13D
2013-07-01Not available in this setting$1,154.54RVU13C
2013-04-01Not available in this setting$1,154.54RVU13B
2013-01-01Not available in this setting$1,154.54RVU13AR

Price 33840 for an earlier date of service

Where the South Carolina rate applies

South Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 475 cities and communities in South Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Abbeville
  • Abney Crossroads
  • Adams Run
  • Aiken
  • Alcolu
  • Allendale
  • Anderson
  • Andrews

Browse all communities in South Carolina

33840 billing questions

How is this code distinguished from 33845?

Use 33840 when the surgeon reconnects the aortic ends directly after removing the narrowed segment. Code 33845 describes excision with graft reconstruction.

What operative documentation supports 33840?

The operative report should identify the coarctation, its excision, and direct anastomosis of the remaining aortic ends. Documentation of an interposition graft or patch points to a different repair method.

Can modifier 50 be appended?

No. The anatomy and descriptor make a bilateral adjustment inappropriate for this repair.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation.

What postoperative care is included?

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
RVUs for 33840PPRRVU2026_Oct_nonQPP.csv, line 4,084 (RVU26D)
Geographic factors for South CarolinaGPCI2026.csv, line 93 (RVU26D)

Open CMS sourceHow we calculate rates

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