FeeBase
Log inGet started
Menu

Billing code 33404: Conduit preparationMedicare rate & RVUs

Reports the surgeon’s preparation of the heart-aorta conduit to receive an aortic valve homograft during open aortic valve surgery.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $1,664.70 for 33404 nationally in a facility.

Medicare rate · 33404

Conduit preparation

Swap in your local Medicare rate.

Work RVUs
30.59
Total RVUs
49.84
Global days
090

National rate · 2026

$1,664.70

Facility setting, before claim adjustments.

See every locality for 33404 → · 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 33404 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 33404 covers

This service covers preparing the recipient heart and aortic outflow tract for an aortic valve homograft during open cardiac surgery. A cardiac surgeon performs the work, typically in an operating room with cardiopulmonary bypass as part of a valve replacement operation. The preparation is distinct from the act of implanting the replacement valve; the operative report should make clear what conduit preparation was performed and how it relates to the valve procedure.

Report the code when the documented operation includes this specific preparation, not simply because a homograft is implanted. Identify the graft type, the relevant anatomy, and the preparation performed. The procedure 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. 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 33404 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

33404 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,508.68
Alaska*Unavailable$2,091.52
ArizonaUnavailable$1,617.10
ArkansasUnavailable$1,489.82
AtlantaUnavailable$1,723.35
AustinUnavailable$1,661.93
BakersfieldUnavailable$1,626.61
Baltimore/Surr. CntysUnavailable$1,768.14
BeaumontUnavailable$1,611.49
BrazoriaUnavailable$1,615.43

33404 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

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
33404 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 33404 rate is calculated

Each of 33404’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 · 33404

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 30.59Practice expense 11.92Malpractice 7.33

49.8400 adjusted RVUs×$33.4009 conversion factor=$1,664.70

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

Payment rules and modifiers for 33404

33404 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 33404

Conduit preparation

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 · 33404

Conduit preparation

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

33404 without 51 · national facility

$1,664.70

Conduit preparation

33404-51 · Second procedure: 50%

$832.35

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

33404 compared with similar codes

Compare codes

33404 vs 33406 vs 33405 vs 33410: national Medicare rates

Swap in your local Medicare rate.

  • 33404
    Conduit preparation · 30.59 wRVU
    —
  • 33406
    Aortic valve replacement · 51.36 wRVU
    —
  • 33405
    Aortic valve replacement · 40.29 wRVU
    —
  • 33410
    Aortic valve replacement · 45.25 wRVU
    —

How to choose

33406Aortic valve replacement
33406 describes aortic valve replacement using a homograft. This code describes preparation of the recipient conduit, which may be performed during that replacement operation.
33405Aortic valve replacement
33405 describes replacement with a prosthetic valve. This code concerns conduit preparation for a homograft rather than prosthetic valve implantation.
33410Aortic valve replacement
33410 describes aortic valve replacement using the patient’s pulmonary valve. This code concerns preparation of the heart-aorta conduit for homograft insertion.

Codes related to 33404

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

Codes related to 33404
CodeHow it relatesNational office range
Often billed with
33406Aortic valve replacementAortic valve homograft replacement may be performed in the same operation as conduit preparation.No office rate
Used instead
33405Aortic valve replacementDescribes aortic valve replacement with a prosthetic valve rather than the conduit-preparation service.No office rate
33410Aortic valve replacementDescribes a different aortic valve replacement approach involving translocation of the patient’s pulmonary valve.No office rate

33404 billing questions

How does this differ from the aortic valve replacement code?

This code represents preparation of the recipient heart-aorta conduit. A separate replacement code describes the valve replacement itself; the operative report should support each reported service.

When is this reported with an aortic homograft replacement?

Report it when the surgeon performs the specified conduit preparation during the operation. Document the preparation separately from the act of implanting the homograft.

Does the code have a 90-day global period?

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

How are multiple 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.

Can an assistant or co-surgeon be reported?

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

Should modifier 50 be used?

No. Bilateral adjustment does not apply to this code.

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 33404PPRRVU2026_Oct_nonQPP.csv, line 3,935 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 33404 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 33404 and the rest of your codes on one sheet

Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.

Build my fee sheetOr price your code list free →