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Billing code 33368: TAVR with bypassMedicare rate & RVUs

Reports cardiopulmonary bypass support during transcatheter aortic valve replacement performed through an open femoral artery approach.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $676.70 for 33368 nationally in a facility.

Medicare rate · 33368

TAVR with bypass

Swap in your local Medicare rate.

Work RVUs
14.03
Total RVUs
20.26
Global days
ZZZ

National rate · 2026

$676.70

Facility setting, before claim adjustments.

See every locality for 33368 → · 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 33368 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 33368 covers

Code 33368 represents cardiopulmonary bypass used during transcatheter aortic valve replacement when the valve is reached through an open femoral artery exposure. The procedure is generally performed by a cardiac surgery team in a hospital operating room for a patient undergoing TAVR who requires bypass support. It is distinct from the TAVR service itself: the open femoral access route and valve replacement are represented by the matching primary procedure code.

Report 33368 only with its qualifying primary TAVR procedure, not as a standalone service. For an open femoral approach, pair it with 33362. The operative report should support the open femoral route and the use of cardiopulmonary bypass during the valve procedure. CMS treats this as an add-on code paid within the primary procedure’s global period, so it does not establish a separate global period.

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 33368 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

33368 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$616.12
Alaska*Unavailable$867.02
ArizonaUnavailable$657.61
ArkansasUnavailable$608.87
AtlantaUnavailable$702.14
AustinUnavailable$670.46
BakersfieldUnavailable$651.09
Baltimore/Surr. CntysUnavailable$717.74
BeaumontUnavailable$660.10
BrazoriaUnavailable$654.97

33368 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
33368 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 33368 rate is calculated

Each of 33368’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 · 33368

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 14.03Practice expense 2.88Malpractice 3.35

20.2600 adjusted RVUs×$33.4009 conversion factor=$676.70

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

Payment rules and modifiers for 33368

The CMS indicators that decide how 33368 is paid alongside other services.

CMS payment indicators · 33368

TAVR with bypass

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)1Permitted with supporting documentation.
Professional/technical0Physician service: no professional/technical split.

33368 compared with similar codes

Compare codes

33368 vs 33362 vs 33367 vs 33369 vs 33361: national Medicare rates

Swap in your local Medicare rate.

  • 33368
    TAVR with bypass · 14.03 wRVU
    —
  • 33362
    Aortic valve replacement · 23.93 wRVU
    —
  • 33367
    TAVR bypass support · 11.58 wRVU
    —
  • 33369
    Aortic valve replacement · 18.53 wRVU
    —
  • 33361
    TAVR · 21.91 wRVU
    —

How to choose

33362Aortic valve replacement
33362 is the primary TAVR service for open femoral access. Add 33368 when cardiopulmonary bypass is used during that procedure.
33367TAVR bypass support
Both are TAVR bypass add-ons, but they correspond to different access approaches. Select the code matching the primary TAVR approach.
33369Aortic valve replacement
33369 is the bypass add-on for a different TAVR access approach; 33368 corresponds to open femoral access.
33361TAVR
33361 is the primary TAVR code for percutaneous femoral access, not the open femoral approach represented by the 33362 and 33368 pairing.

Codes related to 33368

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

Codes related to 33368
CodeHow it relatesNational office range
Primary code
33362Aortic valve replacementPrimary TAVR code for the open femoral artery approach paired with this bypass add-on.No office rate
Same family
33367TAVR bypass supportBypass add-on in the TAVR series for a different access approach.No office rate
33369Aortic valve replacementBypass add-on in the TAVR series for a different access approach.No office rate
Used instead
33361TAVRTAVR through percutaneous femoral access rather than open femoral access.No office rate
33363TAVRTAVR through open axillary access rather than open femoral access.No office rate

33368 billing questions

Which primary code is paired with 33368?

For TAVR using an open femoral artery approach, report 33368 with primary code 33362. The primary code describes the TAVR access approach; 33368 accounts for the bypass service.

Can 33368 be reported by itself?

No. It is an add-on code and must be reported with the qualifying primary procedure.

How is 33368 different from 33362?

Code 33362 represents TAVR through open femoral access. Code 33368 is the add-on for cardiopulmonary bypass used during that procedure.

What documentation supports 33368?

The operative record should identify the open femoral access route and document cardiopulmonary bypass use during TAVR.

Does 33368 have its own global period?

No. CMS pays this add-on within the global period of the primary procedure.

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 33368PPRRVU2026_Oct_nonQPP.csv, line 3,930 (RVU26D)

Open CMS sourceHow we calculate rates

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