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Billing code 33335: Aortic graftMedicare rate & RVUs

Reports placement of an aortic graft during open surgery using cardiopulmonary bypass to support circulation while the aorta is treated.

CMS RVU26DEffective Oct 1, 2026109 payment localities55 Medicare services in 2024

Medicare pays $1,768.91 for 33335 nationally in a facility.

Medicare rate · 33335

Aortic graft

Work RVUs
33.06
Total RVUs
52.96
Global days
090

National rate · 2026

$1,768.91

Facility setting, before claim adjustments.

See every locality for 33335 →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 33335 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 33335 covers

This code captures placement of an aortic graft during an operation that uses cardiopulmonary bypass (CPB). A cardiac surgeon performs the reconstruction in an operating room, commonly when an aortic segment requires graft replacement or reconstruction. CPB supports circulation while the aorta is treated. The operative report should identify the aortic work and document use of bypass.

Report the code when the documented service is aortic graft placement with CPB, rather than direct vessel repair or graft placement without bypass. Documentation should establish the aortic segment treated, graft reconstruction, and CPB. The code has a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. For same-session multiple procedures, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. An assistant at surgery may be paid; 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 33335 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

33335 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,603.98
Alaska*Unavailable$2,228.09
ArizonaUnavailable$1,718.38
ArkansasUnavailable$1,584.08
AtlantaUnavailable$1,831.86
AustinUnavailable$1,764.11
BakersfieldUnavailable$1,724.71
Baltimore/Surr. CntysUnavailable$1,878.54
BeaumontUnavailable$1,714.12
BrazoriaUnavailable$1,715.88

33335 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
33335 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 33335 rate is calculated

Each of 33335’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 · 33335

RVUs × geographic indexes × conversion factor

Work33.06

33.06 RVUs× 1.000 GPCI

Practice expense11.97

11.97 RVUs× 1.000 GPCI

Malpractice7.93

7.93 RVUs× 1.000 GPCI

Adjusted RVUs

52.9600

Conversion factor

$33.4009

Medicare rate

$1,768.91

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

Payment rules and modifiers for 33335

33335 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 33335

Aortic graft

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 · 33335

Aortic graft

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

33335 without 51 · national facility

$1,768.91

Aortic graft

33335-51 · Second procedure: 50%

$884.46

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

33335 compared with similar codes

Compare codes · National

4 codes, side by side

  • 33335

    Aortic graft33.06 wRVU

    Not priced

  • 33330

    Vessel graft24.66 wRVU

    Not priced

  • 33320

    Major vessel repair18.08 wRVU

    Not priced

  • 33321

    Vessel repair20.29 wRVU

    Not priced

How to choose

33330Vessel graft
Choose 33335 when the aortic graft operation uses cardiopulmonary bypass. Code 33330 describes the related graft procedure without bypass.
33320Major vessel repair
Code 33320 is for direct repair of an intrathoracic blood vessel. Use 33335 for aortic graft placement with cardiopulmonary bypass.
33321Vessel repair
Code 33321 concerns intrathoracic vessel repair using a graft; 33335 is specific to aortic graft placement with cardiopulmonary bypass.

Codes related to 33335

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

Codes related to 33335
CodeHow it relatesNational office range
Same family
33330Vessel graftRelated aortic graft placement code for operations performed without cardiopulmonary bypass.No office rate
Used instead
33320Major vessel repairFor direct repair of an intrathoracic blood vessel rather than aortic graft placement.No office rate
33321Vessel repairFor intrathoracic vessel repair using a graft, rather than this aortic graft placement service.No office rate
33322Vessel repairFor intrathoracic vessel repair using a patch graft.No office rate

33335 billing questions

How does this code differ from 33330?

Both concern aortic graft placement, but 33335 is for an operation using cardiopulmonary bypass. Code 33330 is the related option when bypass is not used.

What documentation supports reporting this code?

The operative report should describe the aortic segment treated, graft placement or reconstruction, and use of cardiopulmonary bypass.

Are related postoperative visits separately included?

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

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, while team surgery is not permitted.

Can modifier 50 be used for bilateral work?

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

How are additional procedures in the same session paid?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%.

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 33335PPRRVU2026_Oct_nonQPP.csv, line 3,921 (RVU26D)

Open CMS sourceHow we calculate rates

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