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Billing code 33622: Congenital heart surgeryMedicare rate & RVUs

Reports repeat open surgery for a complex congenital heart defect, such as tetralogy of Fallot or transposition of the great arteries, using cardiopulmonary bypass.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $3,159.06 for 33622 nationally in a facility.

Medicare rate · 33622

Congenital heart surgery

Swap in your local Medicare rate.

Work RVUs
62.4
Total RVUs
94.58
Global days
090

National rate · 2026

$3,159.06

Facility setting, before claim adjustments.

See every locality for 33622 → · 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 33622 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 33622 covers

This code represents a repeat open operation for complex congenital heart disease requiring cardiopulmonary bypass. Examples include reoperation for tetralogy of Fallot, transposition of the great arteries, or double-outlet right ventricle. A congenital cardiac surgeon typically performs the operation in a hospital operating room; patients may be children or adults with congenital heart disease who need further surgical correction after an earlier procedure.

Select the code when the operative record supports both a prior cardiac operation and a complex redo procedure, rather than a first-time repair or a separately defined operation. Documentation should identify the congenital anatomy, prior repair, current surgical work, and use of bypass. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; 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 33622 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

33622 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$2,862.25
Alaska*Unavailable$4,000.80
ArizonaUnavailable$3,066.33
ArkansasUnavailable$2,826.65
AtlantaUnavailable$3,279.77
AustinUnavailable$3,135.14
BakersfieldUnavailable$3,045.81
Baltimore/Surr. CntysUnavailable$3,357.09
BeaumontUnavailable$3,072.31
BrazoriaUnavailable$3,055.13

33622 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.

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View every state and territory as a table
33622 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 33622 rate is calculated

Each of 33622’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 · 33622

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 62.40Practice expense 16.44Malpractice 15.74

94.5800 adjusted RVUs×$33.4009 conversion factor=$3,159.06

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

Payment rules and modifiers for 33622

33622 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 33622

Congenital heart surgery

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 · 33622

Congenital heart surgery

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

33622 without 51 · national facility

$3,159.06

Congenital heart surgery

33622-51 · Second procedure: 50%

$1,579.53

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

33622 compared with similar codes

Compare codes

33622 vs 33608 vs 33611 vs 33615: national Medicare rates

Swap in your local Medicare rate.

  • 33622
    Congenital heart surgery · 62.4 wRVU
    —
  • 33608
    Conduit repair · 31.08 wRVU
    —
  • 33611
    Congenital heart repair · 34.68 wRVU
    —
  • 33615
    Fontan repair · 34.99 wRVU
    —

How to choose

33608Conduit repair
33608 identifies a congenital repair using a conduit. This code is for a complex repeat operation after prior cardiac surgery, not simply for conduit use.
33611Congenital heart repair
33611 describes a defined double-outlet right ventricle repair. Choose this code when the service is a complex redo operation that meets its criteria.
33615Fontan repair
33615 is specific to a Fontan procedure. This code describes a complex reoperation and is not selected merely because the patient has single-ventricle physiology.

Codes related to 33622

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

Codes related to 33622
CodeHow it relatesNational office range
Used instead
33608Conduit repairA conduit-based congenital repair may be coded by its defined procedure rather than as a complex redo.No office rate
33611Congenital heart repairA defined double-outlet right ventricle repair may be reported when that operation is performed.No office rate
33615Fontan repairA Fontan procedure has its own code when that specific operation is performed.No office rate
33617Single-ventricle repairA defined single-ventricle repair may be coded by the operation performed.No office rate

33622 billing questions

When should this code be selected instead of a code for a specific congenital repair?

Use it for a complex redo operation after prior cardiac surgery when the procedure fits this service. A code for a defined repair, such as a double-outlet right ventricle repair, may be more appropriate when that specific operation is performed.

What documentation supports reporting a redo procedure?

The operative report should establish the prior cardiac operation, the complex congenital anatomy, the current surgical work, and use of cardiopulmonary bypass.

How is this code affected when other procedures are performed in the same session?

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

Can modifier 50 be used?

No. The anatomy and service are not coded as bilateral, so modifier 50 is inappropriate.

How are assistant and co-surgeon services handled?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; 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 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 33622PPRRVU2026_Oct_nonQPP.csv, line 4,020 (RVU26D)

Open CMS sourceHow we calculate rates

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