CPT code 33864: Aortic graft, with root replacement and CABG2026 Medicare rate & RVUs in Guam
Reports ascending aortic replacement with a valved root conduit, coronary reconstruction, and coronary artery bypass grafting during the same operation.
CMS doesn’t publish an office rate for 33864 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 33864 covers
This code describes replacement of the ascending aorta and aortic root with a valved conduit, reconstruction of the coronary arteries, and coronary artery bypass grafting during the same operation. Cardiac surgeons typically perform this open procedure in a hospital operating room, often using cardiopulmonary bypass. A Bentall-type root replacement is a familiar example; coronary reimplantation into the conduit is distinct from bypass grafting to a diseased coronary artery.
Choose this code when the operative report supports the root conduit, coronary reconstruction, and CABG combination. Document the aortic and root work, the coronary reconstruction, and the bypass grafting performed. 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 other procedures are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; 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.
33864 in Hawaii, Guam, HI
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam, HI | Unavailable | $2,835.91 |
How the 33864 rate is calculated
Each of 33864’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 · 33864
RVUs × geographic indexes × conversion factor
Work58.58
58.58 RVUs× 1.000 GPCI
Practice expense15.81
15.81 RVUs× 1.000 GPCI
Malpractice14.42
14.42 RVUs× 1.000 GPCI
Adjusted RVUs
88.8100
Conversion factor
$33.4009
Medicare rate
$2,966.33
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33864
33864 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33864
Aortic graft, with root replacement and CABG
| 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 · 33864
Aortic graft, with root replacement and CABG
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
33864 without 51 · national facility
$2,966.33
Aortic graft, with root replacement and CABG
33864-51 · Second procedure: 50%
$1,483.17
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%).
33864 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 33863Aortic graftValve conduit, coronary reconstruction
- Both include ascending aortic root replacement with a valved conduit and coronary reconstruction. Select 33864 when CABG is also performed; 33863 is the corresponding root procedure without that CABG distinction.
- 33858Aortic graftAscending aorta, dissection
- This code covers ascending aortic replacement for aortic disease other than dissection without root replacement using a valved conduit. It does not represent the combined root-and-CABG operation.
- 33859Aortic graftNon-dissection disease
- This code covers ascending aortic replacement for dissection without root replacement using a valved conduit. Use 33864 for the root conduit, coronary reconstruction, and CABG combination.
33864 billing questions
How does this differ from 33863?
Both describe ascending aortic root replacement using a valved conduit with coronary reconstruction. Use 33864 when coronary artery bypass grafting is also performed as part of the operation; 33863 describes the root procedure without that CABG distinction.
Does coronary reimplantation count as CABG?
No. Reimplanting the coronary ostia into the conduit is coronary reconstruction, not bypass grafting. The operative report must support actual CABG for this code's added distinction.
What supports reporting this code?
The operative report should document replacement of the ascending aorta and root with a valved conduit, coronary reconstruction, and coronary artery bypass grafting.
Can modifier 50 be reported?
No. The anatomy and procedure do not support a bilateral adjustment.
How are assistant and co-surgeon services handled?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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
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