CPT code 33853: Aortic arch repair, with bypass2026 Medicare rate & RVUs in Texas
Reports surgical reconstruction of a hypoplastic aortic arch using bypass, typically for congenital arch narrowing requiring open cardiac repair.
CMS doesn’t publish an office rate for 33853 in Texas.
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 33853 covers
A cardiothoracic surgeon reconstructs an underdeveloped aortic arch using cardiopulmonary bypass. The procedure is typically performed in a hospital operating room for congenital heart disease, including in infants and children when the arch is too small to provide adequate blood flow. The operative report should establish the arch abnormality and describe the reconstruction and use of bypass.
Select this code when the surgeon repairs the hypoplastic arch with bypass; the corresponding repair without bypass is a different code. The bypass approach is part of the service represented here, rather than a reason to separately report the no-bypass sibling. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. 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. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation. Team surgery is not permitted, and modifier 50 is inappropriate.
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 33853 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | $1,724.97 |
| Beaumont, TX | Unavailable | $1,674.51 |
| Brazoria, TX | Unavailable | $1,675.95 |
| Dallas, TX | Unavailable | $1,699.85 |
| Fort Worth, TX | Unavailable | $1,699.28 |
| Galveston, TX | Unavailable | $1,689.57 |
| Houston, TX | Unavailable | $1,835.82 |
| Rest of Texas | Unavailable | $1,683.33 |
How the 33853 rate is calculated
Each of 33853’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 · 33853
RVUs × geographic indexes × conversion factor
Work31.70
31.70 RVUs× 1.000 GPCI
Practice expense12.10
12.10 RVUs× 1.000 GPCI
Malpractice7.99
7.99 RVUs× 1.000 GPCI
Adjusted RVUs
51.7900
Conversion factor
$33.4009
Medicare rate
$1,729.83
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33853
33853 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33853
Aortic arch repair, with bypass
| 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 · 33853
Aortic arch repair, with bypass
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
33853 without 51 · national facility
$1,729.83
Aortic arch repair, with bypass
33853-51 · Second procedure: 50%
$864.92
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%).
33853 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 33852Aortic arch repairWithout bypass
- Use 33853 when bypass is used for hypoplastic aortic arch repair. Code 33852 is the corresponding repair without bypass.
- 33840Coarctation repairDirect anastomosis
- Code 33840 describes excision of aortic coarctation with direct anastomosis. This code is for hypoplastic arch repair performed with bypass.
- 33845Coarctation repairGraft reconstruction
- Code 33845 describes coarctation excision with graft. Choose 33853 for hypoplastic arch reconstruction with bypass, rather than selecting by graft use alone.
33853 billing questions
How does this differ from 33852?
Both codes address repair of a hypoplastic aortic arch. Choose 33853 when the repair is performed with bypass; 33852 describes the repair without bypass.
Is the bypass separately reported?
Bypass is part of the service represented by 33853. Its use supports choosing this code over 33852; it is not a separate reason to report the no-bypass code.
Can modifier 50 be used?
No. CMS identifies bilateral adjustment as inappropriate for this code because of its descriptor or anatomy.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation.
What postoperative care is included in the global period?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
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% when performed in the same session.
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
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