CPT 33778: Arterial switch repairMedicare rate & RVUs

Medicare pays $2,190.77 for 33778 nationally in a facility.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 33778 covers

This open-heart repair corrects transposition of the great arteries by restoring the aorta and pulmonary artery to the appropriate ventricular outflows. The surgeon divides and reconnects the great vessels and reconstructs their roots; coronary artery transfer is part of the usual arterial-switch approach. Congenital cardiac surgeons perform the operation in an operating room, often for infants with dextro-transposition of the great arteries.

Select this code when the documented operation includes the aortic and pulmonary artery reconstruction described by this repair, rather than an atrial-baffle repair or a separately specified reconstruction variant. The operative report should identify the anatomy, repair technique, great-vessel reconstruction, and any associated work such as VSD closure or relief of subpulmonary obstruction. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same 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 available; 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 33778 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

33778 rates by state

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

How the 33778 rate is calculated

Each of 33778’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.

Payment rules and modifiers for 33778

33778 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

33778 compared with similar codes

How to choose

33779Arterial switch repair

Use 33779 when the transposition reconstruction also includes removal of a pulmonary artery band, as documented in the operative report.

33780Transposition repair

Use 33780 for the reconstruction variant that includes VSD closure; 33778 describes the great-vessel reconstruction without that specified variant.

33781Transposition repair

Use 33781 when the reconstruction includes repair of subpulmonary obstruction, rather than the reconstruction represented by 33778 alone.

33774Atrial baffle repair

Code 33774 represents an atrial-baffle repair. Code 33778 represents a great-vessel reconstruction approach.

Codes related to 33778

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

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

Open CMS sourceHow we calculate rates