No office rate
33405 describes aortic valve replacement without annular enlargement through a transventricular approach. Choose 33413 when the operative report supports both added features.
On this page
CMS RVU26D · Effective 2026-10-01
33413 Aortic valve replacement Medicare reimbursement rates
Reports open aortic valve replacement that includes enlargement of the aortic annulus through a transventricular approach. Compare 33413 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 33413?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 33413 pays more and less
Cardiac surgery
About 33413: Aortic valve replacement with annular enlargement
Reports open aortic valve replacement that includes enlargement of the aortic annulus through a transventricular approach.
This code describes open surgical replacement of the aortic valve combined with enlargement of the aortic annulus using a transventricular approach. A cardiothoracic surgeon may perform this operation when the annulus must be enlarged to accommodate the replacement valve. The procedure involves work beyond replacing the valve alone, including the annular enlargement and ventricular approach.
Report 33413 when the operative report supports both annular enlargement and the transventricular approach; valve replacement by itself does not establish this code. Documentation should identify the replacement, the enlargement, and the approach. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care for 90 days. 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.
CMS billing rules for 33413
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU58.37 · 65%
- Practice expense (office) RVU17.90 · 20%
- Malpractice RVU14.00 · 16%
23
Medicare services in 2024 · #5842 by national volume
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.
33413 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
33411 includes a transventricular approach but not annular enlargement. 33413 includes both.
No office rate
33412 includes annular enlargement without a transventricular approach. 33413 includes the enlargement and the transventricular approach.
No office rate
33414 is for repair of the aortic valve. Use 33413 when the valve is replaced and the annulus is enlarged through a transventricular approach.
See how rates vary across the country
33413 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Compare 33413 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office Unavailable | Facility $2737.42 |
| Alaska* | Office Unavailable | Facility $3818.81 |
| Arizona | Office Unavailable | Facility $2929.23 |
| Arkansas | Office Unavailable | Facility $2704.01 |
| Atlanta | Office Unavailable | Facility $3124.50 |
| Austin | Office Unavailable | Facility $3000.37 |
| Bakersfield | Office Unavailable | Facility $2926.70 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $3200.76 |
| Beaumont | Office Unavailable | Facility $2928.09 |
| Brazoria | Office Unavailable | Facility $2922.44 |
| Chicago | Office Unavailable | Facility $3637.29 |
| Chico | Office Unavailable | Facility $2888.67 |
| Colorado | Office Unavailable | Facility $2974.35 |
| Connecticut | Office Unavailable | Facility $3198.33 |
| Dallas | Office Unavailable | Facility $2963.85 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $3279.64 |
| Delaware | Office Unavailable | Facility $2970.44 |
| Detroit | Office Unavailable | Facility $3314.96 |
| East St. Louis | Office Unavailable | Facility $3441.43 |
| El Centro | Office Unavailable | Facility $2891.00 |
| Fort Lauderdale | Office Unavailable | Facility $3400.70 |
| Fort Worth | Office Unavailable | Facility $2963.95 |
| Fresno | Office Unavailable | Facility $2888.67 |
| Galveston | Office Unavailable | Facility $2946.08 |
| Hanford-Corcoran | Office Unavailable | Facility $2888.67 |
| Hawaii, Guam | Office Unavailable | Facility $2900.14 |
| Houston | Office Unavailable | Facility $3202.33 |
| Idaho | Office Unavailable | Facility $2720.84 |
| Indiana | Office Unavailable | Facility $2731.10 |
| Iowa | Office Unavailable | Facility $2682.31 |
| Kansas | Office Unavailable | Facility $2725.77 |
| Kentucky | Office Unavailable | Facility $2908.99 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $3047.33 |
| Madera | Office Unavailable | Facility $2888.67 |
| Manhattan | Office Unavailable | Facility $3510.75 |
| Merced | Office Unavailable | Facility $2888.67 |
| Metropolitan Boston | Office Unavailable | Facility $3159.58 |
| Metropolitan Kansas City | Office Unavailable | Facility $2967.87 |
| Metropolitan Philadelphia | Office Unavailable | Facility $3164.95 |
| Metropolitan St. Louis | Office Unavailable | Facility $2987.34 |
| Miami | Office Unavailable | Facility $3754.59 |
| Minnesota | Office Unavailable | Facility $2703.24 |
| Mississippi | Office Unavailable | Facility $2809.95 |
| Modesto | Office Unavailable | Facility $2888.67 |
| Montana** | Office Unavailable | Facility $3014.16 |
| Napa | Office Unavailable | Facility $3097.98 |
| Nebraska | Office Unavailable | Facility $2678.21 |
| Nevada** | Office Unavailable | Facility $2937.61 |
| New Hampshire | Office Unavailable | Facility $2981.16 |
| New Mexico | Office Unavailable | Facility $3059.47 |
| New Orleans | Office Unavailable | Facility $3043.42 |
| North Carolina | Office Unavailable | Facility $2806.23 |
| North Dakota** | Office Unavailable | Facility $2737.34 |
| Northern Nj | Office Unavailable | Facility $3265.38 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $3653.62 |
| Ohio | Office Unavailable | Facility $2966.82 |
| Oklahoma | Office Unavailable | Facility $2846.85 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $3002.21 |
| Portland | Office Unavailable | Facility $2992.95 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $3257.83 |
| Puerto Rico | Office Unavailable | Facility $3014.66 |
| Queens | Office Unavailable | Facility $3455.37 |
| Redding | Office Unavailable | Facility $2888.67 |
| Rest Of California | Office Unavailable | Facility $2888.67 |
| Rest Of Florida | Office Unavailable | Facility $3224.00 |
| Rest Of Georgia | Office Unavailable | Facility $3040.31 |
| Rest Of Illinois | Office Unavailable | Facility $3226.35 |
| Rest Of Louisiana | Office Unavailable | Facility $2926.70 |
| Rest Of Maine | Office Unavailable | Facility $2790.51 |
| Rest Of Maryland | Office Unavailable | Facility $3003.43 |
| Rest Of Massachusetts | Office Unavailable | Facility $2983.06 |
| Rest Of Michigan | Office Unavailable | Facility $3023.41 |
| Rest Of Missouri | Office Unavailable | Facility $2920.43 |
| Rest Of New Jersey | Office Unavailable | Facility $3193.45 |
| Rest Of New York | Office Unavailable | Facility $2846.32 |
| Rest Of Oregon | Office Unavailable | Facility $2873.83 |
| Rest Of Pennsylvania | Office Unavailable | Facility $2940.35 |
| Rest Of Texas | Office Unavailable | Facility $2939.25 |
| Rest Of Washington | Office Unavailable | Facility $2960.37 |
| Rhode Island | Office Unavailable | Facility $3021.37 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $3038.85 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $2965.77 |
| Salinas | Office Unavailable | Facility $2953.63 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $2976.60 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $3192.46 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $3176.56 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $3276.85 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $3211.85 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $2914.38 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $2967.61 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $2951.96 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $2992.93 |
| Seattle (King Cnty) | Office Unavailable | Facility $3162.72 |
| South Carolina | Office Unavailable | Facility $2899.52 |
| South Dakota** | Office Unavailable | Facility $2704.60 |
| Southern Maine | Office Unavailable | Facility $2837.17 |
| Stockton | Office Unavailable | Facility $2888.67 |
| Suburban Chicago | Office Unavailable | Facility $3405.89 |
| Tennessee | Office Unavailable | Facility $2744.19 |
| Utah | Office Unavailable | Facility $2931.53 |
| Vallejo | Office Unavailable | Facility $3075.07 |
| Vermont | Office Unavailable | Facility $2778.12 |
| Virgin Islands | Office Unavailable | Facility $3014.66 |
| Virginia | Office Unavailable | Facility $2867.46 |
| Visalia | Office Unavailable | Facility $2888.67 |
| West Virginia | Office Unavailable | Facility $3138.32 |
| Wisconsin | Office Unavailable | Facility $2666.40 |
| Wyoming** | Office Unavailable | Facility $2893.52 |
| Yuba City | Office Unavailable | Facility $2888.67 |
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33413 billing questions
When should 33413 be chosen over 33405?
Use 33413 when the aortic valve replacement includes annular enlargement through a transventricular approach. 33405 describes aortic valve replacement without those added features.
How does 33413 differ from 33412?
33413 includes annular enlargement and a transventricular approach. 33412 describes annular enlargement without the transventricular approach.
What operative documentation supports 33413?
The report should document aortic valve replacement, enlargement of the aortic annulus, and use of the transventricular approach.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures in that session 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, and team surgery is not permitted.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
3,93933410,,Replacement aortic valve opn,A,,45.25,14.84,NA,14.84,,11.28,71.37,71.37,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,94033411,,Replacement of aortic valve,A,,60.52,17.88,NA,17.88,,14.94,93.34,93.34,0,090,0.09,0.84,0.07,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,94133412,,Replacement of aortic valve,A,,57.53,16.47,NA,16.47,,13.82,87.82,87.82,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,94233413,,Replacement of aortic valve,A,,58.37,17.90,NA,17.90,,14.00,90.27,90.27,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,94333414,,Repair of aortic valve,A,,38.39,11.69,NA,11.69,,9.70,59.78,59.78,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,94433415,,Revision subvalvular tissue,A,,36.34,11.67,NA,11.67,,9.00,57.01,57.01,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,94533416,,Revise ventricle muscle,A,,35.65,12.53,NA,12.53,,8.77,56.95,56.95,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00