No office rate
Use 33853 when the hypoplastic arch repair is performed with cardiopulmonary bypass. This code identifies the repair performed without bypass.
On this page
CMS RVU26D · Effective 2026-10-01
33852 Aortic arch repair Medicare reimbursement rates
Open repair of an underdeveloped aortic arch performed without cardiopulmonary bypass, reported when the operative approach and bypass status match this service. Compare 33852 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 33852?
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 33852 pays more and less
Cardiothoracic surgery
About 33852: Hypoplastic aortic arch repair without bypass
Open repair of an underdeveloped aortic arch performed without cardiopulmonary bypass, reported when the operative approach and bypass status match this service.
This service addresses an underdeveloped, narrowed aortic arch, often in a patient with congenital heart disease such as coarctation. A cardiothoracic surgeon performs the open repair without cardiopulmonary bypass. The operative report should establish that the arch hypoplasia was repaired and describe the operative approach and whether bypass was used; the diagnosis alone does not distinguish this code from its bypass counterpart.
Report this code for the repair without bypass, rather than the related arch-repair code for a procedure performed with bypass. CMS assigns a 90-day global period, including the day before surgery and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to a 50% reduction. Modifier 50 is inappropriate for this service. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted under the listed CMS rules.
CMS billing rules for 33852
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU23.80 · 60%
- Practice expense (office) RVU10.04 · 25%
- Malpractice RVU6.00 · 15%
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.
33852 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
33840 describes coarctation excision with direct anastomosis. Choose based on the operative service documented, not simply the presence of a narrowed aorta.
No office rate
33845 is for coarctation excision with graft. It differs from repair of an underdeveloped arch without bypass.
No office rate
33871 describes transverse aortic arch grafting with hypothermic circulatory arrest, not the hypoplastic arch repair without bypass represented here.
See how rates vary across the country
33852 · 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 33852 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 $1201.80 |
| Alaska* | Office Unavailable | Facility $1659.98 |
| Arizona | Office Unavailable | Facility $1291.44 |
| Arkansas | Office Unavailable | Facility $1186.21 |
| Atlanta | Office Unavailable | Facility $1378.72 |
| Austin | Office Unavailable | Facility $1328.89 |
| Bakersfield | Office Unavailable | Facility $1299.63 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $1415.39 |
| Beaumont | Office Unavailable | Facility $1286.28 |
| Brazoria | Office Unavailable | Facility $1289.94 |
| Chicago | Office Unavailable | Facility $1597.46 |
| Chico | Office Unavailable | Facility $1283.41 |
| Colorado | Office Unavailable | Facility $1317.80 |
| Connecticut | Office Unavailable | Facility $1414.50 |
| Dallas | Office Unavailable | Facility $1308.05 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $1455.96 |
| Delaware | Office Unavailable | Facility $1310.40 |
| Detroit | Office Unavailable | Facility $1456.43 |
| East St. Louis | Office Unavailable | Facility $1507.08 |
| El Centro | Office Unavailable | Facility $1284.41 |
| Fort Lauderdale | Office Unavailable | Facility $1496.98 |
| Fort Worth | Office Unavailable | Facility $1307.30 |
| Fresno | Office Unavailable | Facility $1283.41 |
| Galveston | Office Unavailable | Facility $1300.23 |
| Hanford-Corcoran | Office Unavailable | Facility $1283.41 |
| Hawaii, Guam | Office Unavailable | Facility $1292.26 |
| Houston | Office Unavailable | Facility $1410.06 |
| Idaho | Office Unavailable | Facility $1198.25 |
| Indiana | Office Unavailable | Facility $1203.20 |
| Iowa | Office Unavailable | Facility $1181.34 |
| Kansas | Office Unavailable | Facility $1199.10 |
| Kentucky | Office Unavailable | Facility $1276.43 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $1357.32 |
| Madera | Office Unavailable | Facility $1283.41 |
| Manhattan | Office Unavailable | Facility $1553.33 |
| Merced | Office Unavailable | Facility $1283.41 |
| Metropolitan Boston | Office Unavailable | Facility $1406.30 |
| Metropolitan Kansas City | Office Unavailable | Facility $1305.63 |
| Metropolitan Philadelphia | Office Unavailable | Facility $1397.43 |
| Metropolitan St. Louis | Office Unavailable | Facility $1315.00 |
| Miami | Office Unavailable | Facility $1650.86 |
| Minnesota | Office Unavailable | Facility $1199.33 |
| Mississippi | Office Unavailable | Facility $1231.77 |
| Modesto | Office Unavailable | Facility $1283.41 |
| Montana** | Office Unavailable | Facility $1330.29 |
| Napa | Office Unavailable | Facility $1388.81 |
| Nebraska | Office Unavailable | Facility $1180.22 |
| Nevada** | Office Unavailable | Facility $1297.56 |
| New Hampshire | Office Unavailable | Facility $1319.39 |
| New Mexico | Office Unavailable | Facility $1343.14 |
| New Orleans | Office Unavailable | Facility $1338.16 |
| North Carolina | Office Unavailable | Facility $1235.88 |
| North Dakota** | Office Unavailable | Facility $1211.65 |
| Northern Nj | Office Unavailable | Facility $1448.06 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $1616.70 |
| Ohio | Office Unavailable | Facility $1303.12 |
| Oklahoma | Office Unavailable | Facility $1250.12 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $1338.43 |
| Portland | Office Unavailable | Facility $1329.33 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $1440.41 |
| Puerto Rico | Office Unavailable | Facility $1331.37 |
| Queens | Office Unavailable | Facility $1531.18 |
| Redding | Office Unavailable | Facility $1283.41 |
| Rest Of California | Office Unavailable | Facility $1283.41 |
| Rest Of Florida | Office Unavailable | Facility $1416.74 |
| Rest Of Georgia | Office Unavailable | Facility $1332.95 |
| Rest Of Illinois | Office Unavailable | Facility $1414.35 |
| Rest Of Louisiana | Office Unavailable | Facility $1283.71 |
| Rest Of Maine | Office Unavailable | Facility $1228.11 |
| Rest Of Maryland | Office Unavailable | Facility $1326.23 |
| Rest Of Massachusetts | Office Unavailable | Facility $1320.50 |
| Rest Of Michigan | Office Unavailable | Facility $1327.37 |
| Rest Of Missouri | Office Unavailable | Facility $1279.20 |
| Rest Of New Jersey | Office Unavailable | Facility $1412.78 |
| Rest Of New York | Office Unavailable | Facility $1254.40 |
| Rest Of Oregon | Office Unavailable | Facility $1269.83 |
| Rest Of Pennsylvania | Office Unavailable | Facility $1292.17 |
| Rest Of Texas | Office Unavailable | Facility $1294.15 |
| Rest Of Washington | Office Unavailable | Facility $1310.90 |
| Rhode Island | Office Unavailable | Facility $1335.22 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $1347.73 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $1320.98 |
| Salinas | Office Unavailable | Facility $1315.67 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $1328.48 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $1435.28 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $1428.47 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $1473.37 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $1445.51 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $1297.83 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $1326.50 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $1315.63 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $1338.01 |
| Seattle (King Cnty) | Office Unavailable | Facility $1409.89 |
| South Carolina | Office Unavailable | Facility $1275.14 |
| South Dakota** | Office Unavailable | Facility $1197.62 |
| Southern Maine | Office Unavailable | Facility $1253.72 |
| Stockton | Office Unavailable | Facility $1283.41 |
| Suburban Chicago | Office Unavailable | Facility $1500.02 |
| Tennessee | Office Unavailable | Facility $1207.39 |
| Utah | Office Unavailable | Facility $1290.13 |
| Vallejo | Office Unavailable | Facility $1378.99 |
| Vermont | Office Unavailable | Facility $1228.34 |
| Virgin Islands | Office Unavailable | Facility $1331.37 |
| Virginia | Office Unavailable | Facility $1266.07 |
| Visalia | Office Unavailable | Facility $1283.41 |
| West Virginia | Office Unavailable | Facility $1373.14 |
| Wisconsin | Office Unavailable | Facility $1177.93 |
| Wyoming** | Office Unavailable | Facility $1278.59 |
| Yuba City | Office Unavailable | Facility $1283.41 |
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33852 billing questions
How does this code differ from 33853?
The distinction is whether cardiopulmonary bypass is used for the hypoplastic arch repair. This code is for repair without bypass; 33853 is the corresponding repair with bypass.
What operative documentation supports this code?
The operative report should identify the hypoplastic aortic arch repair and document that cardiopulmonary bypass was not used. Include the operative findings and repair performed.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this service.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid under the listed CMS rule. Co-surgeons and team surgery are not permitted.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
What happens when another procedure is performed in the same session?
CMS applies the standard multiple procedure reduction: the highest-valued procedure is paid in full, and the other procedures are subject to a 50% reduction.
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.
4,08533845,,Excision coa w/graft,A,,22.36,10.26,NA,10.26,,5.62,38.24,38.24,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,0863384F,,Ajcc cln cncr stage 1 docd,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4,08733851,,Exc coa rpr l subcl art/prst,A,,21.43,9.58,NA,9.58,,5.39,36.40,36.40,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,08833852,,Rpr hypopl a-arch wo byp,A,,23.80,10.04,NA,10.04,,6.00,39.84,39.84,0,090,0.09,0.84,0.07,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,08933853,,Rpr hypopl a-arch w/byp,A,,31.70,12.10,NA,12.10,,7.99,51.79,51.79,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,09033858,,As-aort grf f/aortic dsj,A,,61.82,16.69,NA,16.69,,15.31,93.82,93.82,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,09133859,,As-aort grf f/ds oth/thn dsj,A,,44.00,12.86,NA,12.86,,10.86,67.72,67.72,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00