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Billing code 33320: Major vessel repairMedicare rate & RVUs

Report this code when a surgeon repairs a major cardiovascular vessel during an operation performed with cardiopulmonary bypass.

CMS RVU26DEffective Oct 1, 2026109 payment localities79 Medicare services in 2024

Medicare pays $1,017.39 for 33320 nationally in a facility.

Medicare rate · 33320

Major vessel repair

Swap in your local Medicare rate.

Work RVUs
18.08
Total RVUs
30.46
Global days
090

National rate · 2026

$1,017.39

Facility setting, before claim adjustments.

See every locality for 33320 → · Billed by an NP, PA or therapist? →

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 10 sections
  1. Medicare rate
  2. What 33320 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 33320 covers

This code describes operative repair of a major blood vessel, such as the aorta or pulmonary artery, when cardiopulmonary bypass is used. Cardiothoracic surgeons typically perform the service in a hospital operating room. The operative report should identify the vessel and the repair performed; the use of bypass distinguishes this service from a comparable repair performed without it.

Choose the code based on the actual vessel procedure and whether cardiopulmonary bypass was used. Documentation should support the vessel involved, the repair technique, and bypass use. This major surgery has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. 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. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this service.

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 33320 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

33320 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$918.74
Alaska*Unavailable$1,268.10
ArizonaUnavailable$987.40
ArkansasUnavailable$906.81
AtlantaUnavailable$1,053.93
AustinUnavailable$1,016.44
BakersfieldUnavailable$994.55
Baltimore/Surr. CntysUnavailable$1,082.16
BeaumontUnavailable$983.06
BrazoriaUnavailable$986.43

33320 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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
33320 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

How the 33320 rate is calculated

Each of 33320’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 · 33320

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 18.08Practice expense 7.83Malpractice 4.55

30.4600 adjusted RVUs×$33.4009 conversion factor=$1,017.39

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 33320

33320 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 33320

Major vessel repair

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 · 33320

Major vessel repair

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

33320 without 51 · national facility

$1,017.39

Major vessel repair

33320-51 · Second procedure: 50%

$508.70

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

33320 compared with similar codes

Compare codes

33320 vs 33321 vs 33330 vs 33335: national Medicare rates

Swap in your local Medicare rate.

  • 33320
    Major vessel repair · 18.08 wRVU
    —
  • 33321
    Vessel repair · 20.29 wRVU
    —
  • 33330
    Vessel graft · 24.66 wRVU
    —
  • 33335
    Aortic graft · 33.06 wRVU
    —

How to choose

33321Vessel repair
Both codes concern major-vessel repair; select 33320 when cardiopulmonary bypass is used and 33321 when it is not.
33330Vessel graft
33320 describes vessel repair with bypass. Consider 33330 when the operative service is insertion of a major-vessel graft.
33335Aortic graft
33335 is in the major-vessel graft insertion family. Use the code matching the documented graft service rather than coding graft insertion as vessel repair.

Codes related to 33320

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 33320
CodeHow it relatesNational office range
Same family
33321Vessel repairMajor-vessel repair counterpart for a procedure performed without cardiopulmonary bypass.No office rate
33322Vessel repairAnother code in the major-vessel repair series; distinguish it by its full descriptor and operative circumstances.No office rate
Used instead
33330Vessel graftDescribes major-vessel graft insertion rather than the repair reported with this code.No office rate
33335Aortic graftA major-vessel graft insertion code to consider when graft placement, rather than repair, is performed.No office rate

33320 billing questions

How does this code differ from 33321?

This code is for major-vessel repair with cardiopulmonary bypass. Code 33321 describes the corresponding repair without bypass.

Should this code be used when a graft is inserted?

Compare the operative service with the major-vessel graft codes, including 33330 and 33335. Those codes describe graft insertion; this code describes vessel repair with bypass.

Can an assistant surgeon be reported?

CMS indicates that assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation.

Can modifier 50 be used for repair of two vessels?

No. Modifier 50 is inappropriate for this code under the CMS bilateral rule. Report the service supported by the operative documentation.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.

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 33320PPRRVU2026_Oct_nonQPP.csv, line 3,917 (RVU26D)

Open CMS sourceHow we calculate rates

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