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CPT 33858: Aortic graftMedicare rate & RVUs

Reports graft replacement of the ascending aorta for dissection, including operations performed with or without cardiopulmonary bypass.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.6K Medicare services in 2024

Medicare pays $3,133.67 for 33858 nationally in a facility.

Medicare rate · 33858

Aortic graft

Swap in your local Medicare rate.

Work RVUs
61.82
Total RVUs
93.82
Global days
090

National rate · 2026

$3,133.67

Facility setting, before claim adjustments.

See every locality for 33858 →

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 33858 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 33858 covers

Code 33858 describes open replacement of the ascending thoracic aorta with a graft to treat aortic dissection, commonly an acute dissection involving the ascending segment. Cardiothoracic surgeons perform this major operation in a hospital operating room. Cardiopulmonary bypass may be used, but its use does not change the code. The procedure addresses the dissected ascending aorta, rather than disease confined to another aortic segment.

Report the code when the operative report supports graft replacement of the ascending aorta specifically for dissection. Documentation should identify the dissection, the segment treated, and the graft replacement performed; distinguish this service from code 33859, for ascending-aortic graft replacement for other disease. The CMS 90-day global includes the day-before preoperative visit and related postoperative care during the following 90 days. For multiple procedures in the same session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. An assistant at surgery may be paid; 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 33858 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

33858 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$2,842.06
Alaska*Unavailable$3,972.73
ArizonaUnavailable$3,042.75
ArkansasUnavailable$2,807.06
AtlantaUnavailable$3,251.57
AustinUnavailable$3,111.84
BakersfieldUnavailable$3,026.48
Baltimore/Surr. CntysUnavailable$3,328.60
BeaumontUnavailable$3,047.19
BrazoriaUnavailable$3,032.67

33858 rates by state

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

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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
33858 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 33858 rate is calculated

Each of 33858’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 · 33858

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 61.82Practice expense 16.69Malpractice 15.31

93.8200 adjusted RVUs×$33.4009 conversion factor=$3,133.67

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

Payment rules and modifiers for 33858

33858 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 33858

Aortic graft

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 · 33858

Aortic graft

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

33858 without 51 · national facility

$3,133.67

Aortic graft

33858-51 · Second procedure: 50%

$1,566.84

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

33858 compared with similar codes

Compare codes

33858 vs 33859 vs 33863 vs 33866: national Medicare rates

Swap in your local Medicare rate.

  • 33858
    Aortic graft · 61.82 wRVU
    —
  • 33859
    Aortic graft · 44 wRVU
    —
  • 33863
    Aortic graft · 57.32 wRVU
    —
  • 33866
    Aortic graft · 17.31 wRVU
    —

How to choose

33859Aortic graft
Both describe ascending-aortic graft replacement. Choose 33858 when the indication is aortic dissection; 33859 applies to other disease.
33863Aortic graft
Compare the operative work with the full descriptor for 33863, which identifies additional operative elements; 33858 is selected for graft replacement specifically for dissection.
33866Aortic graft
Code 33866 describes aortic hemiarch graft work. Use 33858 for ascending-aortic graft replacement for dissection when the reported work is not the hemiarch service described by 33866.

Codes related to 33858

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

Codes related to 33858
CodeHow it relatesNational office range
Same family
33859Aortic graftAscending-aortic graft replacement for disease other than dissection.No office rate
33863Aortic graftRelated ascending-aortic replacement code; distinguish by the additional operative elements in its descriptor.No office rate
33866Aortic graftAortic hemiarch graft code for a different extent of aortic replacement.No office rate

33858 billing questions

When should 33858 be used instead of 33859?

Use 33858 when the ascending aorta is replaced with a graft for dissection. Code 33859 is for ascending-aortic graft replacement for other disease, such as an aneurysm without dissection.

Does cardiopulmonary bypass determine whether 33858 applies?

No. Code 33858 covers ascending-aortic graft replacement for dissection with or without cardiopulmonary bypass.

What postoperative care is included in the global period?

The 90-day global includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeons are paid only with supporting documentation; team surgery is not permitted.

How does the multiple-procedure reduction affect another procedure performed in the same session?

The highest-valued procedure is paid in full, and other procedures performed in the same session are subject to the standard 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 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 33858PPRRVU2026_Oct_nonQPP.csv, line 4,090 (RVU26D)

Open CMS sourceHow we calculate rates

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