CPT code 33863: Aortic graft, valve conduit, coronary reconstruction2026 Medicare rate & RVUs in Missouri
Reports ascending aortic replacement using a valve-containing composite graft with coronary reconstruction, as in a Bentall operation for aortic root disease.
CMS doesn’t publish an office rate for 33863 in Missouri.
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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What 33863 covers
This operation replaces the diseased ascending aorta with a composite conduit that includes a prosthetic aortic valve, then reconnects the coronary arteries to the graft. Cardiac surgeons commonly perform it in a hospital operating room for aortic root or ascending aortic disease when the valve and aorta are addressed together. The operative report should establish the composite valve graft and coronary reconstruction; a simple aortic graft or a valve replacement without this reconstruction describes a different service.
Report the code for the operation documented, including the graft and coronary work; do not separately report the valve replacement that is built into this composite procedure. The 90-day global period includes the day-before preoperative visit and related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this anatomy. 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.
Where 33863 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $2,863.35 |
| Metropolitan St. Louis, MO | Unavailable | $2,881.91 |
| Rest of Missouri | Unavailable | $2,821.97 |
How the 33863 rate is calculated
Each of 33863’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 · 33863
RVUs × geographic indexes × conversion factor
Work57.32
57.32 RVUs× 1.000 GPCI
Practice expense15.54
15.54 RVUs× 1.000 GPCI
Malpractice14.14
14.14 RVUs× 1.000 GPCI
Adjusted RVUs
87.0000
Conversion factor
$33.4009
Medicare rate
$2,905.88
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33863
33863 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33863
Aortic graft, valve conduit, coronary reconstruction
| 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 · 33863
Aortic graft, valve conduit, coronary reconstruction
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
33863 without 51 · national facility
$2,905.88
Aortic graft, valve conduit, coronary reconstruction
33863-51 · Second procedure: 50%
$1,452.94
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%).
33863 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 33858Aortic graftAscending aorta, dissection
- This code describes a composite valve graft with coronary reconstruction. Code 33858 is for ascending aortic replacement for dissection without that combination.
- 33859Aortic graftNon-dissection disease
- Use this code for the composite valve conduit and coronary reconstruction. Code 33859 describes ascending aortic replacement for disease other than dissection without those features.
- 33864Aortic graftWith root replacement and CABG
- Both codes involve a composite valve graft and coronary reconstruction; code 33864 is distinguished by additional operative features documented in the procedure.
- 33866Aortic graftHemiarch extension
- This code covers composite valve-graft replacement with coronary reconstruction. Code 33866 is for an operation involving an aortic hemiarch graft.
33863 billing questions
When is this code chosen over an ascending aortic graft without a valve conduit?
Use this code when the operation uses a composite graft that includes a prosthetic valve and reconstructs the coronary connections. A graft replacement without that combined valve-and-coronary work points to a different code.
Can the aortic valve replacement be reported separately?
The valve replacement is part of the composite conduit service. Do not separately report it as an additional valve procedure for the same work.
What operative documentation supports this code?
The report should identify the composite valve-containing graft, the ascending aortic replacement, and coronary reconstruction or reimplantation. It should also describe the operative extent and any additional procedures performed.
Can an assistant or co-surgeon be reported?
CMS permits assistant-at-surgery payment for this service. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How does the global period affect postoperative services?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Should modifier 50 be used for this operation?
No. The anatomy and descriptor make a bilateral adjustment inappropriate.
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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