No office rate
Choose 33858 for ascending-aortic graft replacement performed for aortic dissection; choose 33859 for a non-dissection condition such as an ascending aneurysm.
On this page
CMS RVU26D · Effective 2026-10-01
33859 Aortic graft Medicare reimbursement rates
Open graft replacement of the ascending aorta for aneurysmal or other non-dissection disease, when the operation does not meet a more specific root-replacement description. Compare 33859 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 33859?
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 33859 pays more and less
Cardiothoracic surgery
About 33859: Ascending aortic graft for non-dissection disease
Open graft replacement of the ascending aorta for aneurysmal or other non-dissection disease, when the operation does not meet a more specific root-replacement description.
A cardiothoracic surgeon uses this code for open graft replacement of the ascending aorta when the underlying condition is not an aortic dissection. A typical case is repair of an ascending aortic aneurysm. These operations are generally performed in an operating room, often with cardiopulmonary bypass. The operative report should establish the treated aortic segment, the non-dissection diagnosis, and the graft replacement performed.
Report this code for the non-dissection ascending-aortic procedure, distinguishing it from dissection repair and from procedures with a more specific aortic-root description. The major-surgery 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 the others at 50%. Modifier 50 is not appropriate for this aortic service. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 33859
- 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 RVU44.00 · 65%
- Practice expense (office) RVU12.86 · 19%
- Malpractice RVU10.86 · 16%
4.8K
Medicare services in 2024 · #1888 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.
33859 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
Code 33863 describes ascending-aortic grafting that includes aortic-root replacement and coronary reimplantation, rather than the non-dissection ascending-aortic service described by 33859.
No office rate
Code 33864 is for ascending-aortic grafting with aortic-valve suspension. Review the operative details to distinguish that work from the service reported with 33859.
No office rate
Code 33866 identifies an operation that includes the aortic hemiarch; 33859 is selected when the documented work does not meet that hemiarch description.
See how rates vary across the country
33859 · 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 33859 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 $2050.79 |
| Alaska* | Office Unavailable | Facility $2861.78 |
| Arizona | Office Unavailable | Facility $2196.36 |
| Arkansas | Office Unavailable | Facility $2025.42 |
| Atlanta | Office Unavailable | Facility $2346.10 |
| Austin | Office Unavailable | Facility $2248.41 |
| Bakersfield | Office Unavailable | Facility $2189.24 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $2402.75 |
| Beaumont | Office Unavailable | Facility $2197.50 |
| Brazoria | Office Unavailable | Facility $2190.00 |
| Chicago | Office Unavailable | Facility $2744.08 |
| Chico | Office Unavailable | Facility $2159.82 |
| Colorado | Office Unavailable | Facility $2227.60 |
| Connecticut | Office Unavailable | Facility $2400.55 |
| Dallas | Office Unavailable | Facility $2221.91 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $2458.72 |
| Delaware | Office Unavailable | Facility $2227.47 |
| Detroit | Office Unavailable | Facility $2495.71 |
| East St. Louis | Office Unavailable | Facility $2595.36 |
| El Centro | Office Unavailable | Facility $2161.63 |
| Fort Lauderdale | Office Unavailable | Facility $2560.58 |
| Fort Worth | Office Unavailable | Facility $2222.33 |
| Fresno | Office Unavailable | Facility $2159.82 |
| Galveston | Office Unavailable | Facility $2208.27 |
| Hanford-Corcoran | Office Unavailable | Facility $2159.82 |
| Hawaii, Guam | Office Unavailable | Facility $2168.04 |
| Houston | Office Unavailable | Facility $2407.05 |
| Idaho | Office Unavailable | Facility $2036.39 |
| Indiana | Office Unavailable | Facility $2044.11 |
| Iowa | Office Unavailable | Facility $2006.67 |
| Kansas | Office Unavailable | Facility $2040.76 |
| Kentucky | Office Unavailable | Facility $2183.40 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $2278.89 |
| Madera | Office Unavailable | Facility $2159.82 |
| Manhattan | Office Unavailable | Facility $2638.11 |
| Merced | Office Unavailable | Facility $2159.82 |
| Metropolitan Boston | Office Unavailable | Facility $2365.59 |
| Metropolitan Kansas City | Office Unavailable | Facility $2227.36 |
| Metropolitan Philadelphia | Office Unavailable | Facility $2375.98 |
| Metropolitan St. Louis | Office Unavailable | Facility $2242.02 |
| Miami | Office Unavailable | Facility $2834.14 |
| Minnesota | Office Unavailable | Facility $2019.00 |
| Mississippi | Office Unavailable | Facility $2107.53 |
| Modesto | Office Unavailable | Facility $2159.82 |
| Montana** | Office Unavailable | Facility $2261.18 |
| Napa | Office Unavailable | Facility $2312.62 |
| Nebraska | Office Unavailable | Facility $2003.21 |
| Nevada** | Office Unavailable | Facility $2201.76 |
| New Hampshire | Office Unavailable | Facility $2234.18 |
| New Mexico | Office Unavailable | Facility $2299.17 |
| New Orleans | Office Unavailable | Facility $2285.90 |
| North Carolina | Office Unavailable | Facility $2102.18 |
| North Dakota** | Office Unavailable | Facility $2046.45 |
| Northern Nj | Office Unavailable | Facility $2447.89 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $2748.01 |
| Ohio | Office Unavailable | Facility $2227.44 |
| Oklahoma | Office Unavailable | Facility $2135.06 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $2244.48 |
| Portland | Office Unavailable | Facility $2240.24 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $2445.02 |
| Puerto Rico | Office Unavailable | Facility $2261.19 |
| Queens | Office Unavailable | Facility $2594.47 |
| Redding | Office Unavailable | Facility $2159.82 |
| Rest Of California | Office Unavailable | Facility $2159.82 |
| Rest Of Florida | Office Unavailable | Facility $2425.46 |
| Rest Of Georgia | Office Unavailable | Facility $2285.16 |
| Rest Of Illinois | Office Unavailable | Facility $2428.76 |
| Rest Of Louisiana | Office Unavailable | Facility $2197.28 |
| Rest Of Maine | Office Unavailable | Facility $2090.43 |
| Rest Of Maryland | Office Unavailable | Facility $2252.02 |
| Rest Of Massachusetts | Office Unavailable | Facility $2234.55 |
| Rest Of Michigan | Office Unavailable | Facility $2271.33 |
| Rest Of Missouri | Office Unavailable | Facility $2193.20 |
| Rest Of New Jersey | Office Unavailable | Facility $2395.40 |
| Rest Of New York | Office Unavailable | Facility $2132.70 |
| Rest Of Oregon | Office Unavailable | Facility $2152.46 |
| Rest Of Pennsylvania | Office Unavailable | Facility $2206.74 |
| Rest Of Texas | Office Unavailable | Facility $2204.82 |
| Rest Of Washington | Office Unavailable | Facility $2217.09 |
| Rhode Island | Office Unavailable | Facility $2264.83 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $2276.28 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $2216.52 |
| Salinas | Office Unavailable | Facility $2207.46 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $2224.06 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $2381.40 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $2369.06 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $2445.12 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $2394.70 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $2178.29 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $2216.81 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $2206.05 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $2235.62 |
| Seattle (King Cnty) | Office Unavailable | Facility $2366.52 |
| South Carolina | Office Unavailable | Facility $2174.85 |
| South Dakota** | Office Unavailable | Facility $2021.05 |
| Southern Maine | Office Unavailable | Facility $2124.19 |
| Stockton | Office Unavailable | Facility $2159.82 |
| Suburban Chicago | Office Unavailable | Facility $2563.82 |
| Tennessee | Office Unavailable | Facility $2054.88 |
| Utah | Office Unavailable | Facility $2199.14 |
| Vallejo | Office Unavailable | Facility $2294.85 |
| Vermont | Office Unavailable | Facility $2078.42 |
| Virgin Islands | Office Unavailable | Facility $2261.19 |
| Virginia | Office Unavailable | Facility $2147.96 |
| Visalia | Office Unavailable | Facility $2159.82 |
| West Virginia | Office Unavailable | Facility $2361.98 |
| Wisconsin | Office Unavailable | Facility $1992.86 |
| Wyoming** | Office Unavailable | Facility $2167.60 |
| Yuba City | Office Unavailable | Facility $2159.82 |
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33859 billing questions
How does this differ from 33858?
Code 33859 is for ascending-aortic graft replacement for disease other than dissection. Code 33858 is the corresponding choice when the indication is aortic dissection.
When should a root-replacement code be considered instead?
Use a root-specific code when the operation includes the aortic-root work described by that code, rather than graft replacement limited to the ascending aorta. The operative report should identify the extent of resection and reconstruction.
Are related postoperative visits included?
The global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
Should modifier 50 be appended for bilateral work?
No. Modifier 50 is not appropriate for this ascending-aortic service.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, with other procedures in the same session paid at 50%.
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.
4,08833852,,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
4,09233863,,Ascending aortic graft,A,,57.32,15.54,NA,15.54,,14.14,87.00,87.00,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,09333864,,Ascending aortic graft,A,,58.58,15.81,NA,15.81,,14.42,88.81,88.81,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,09433866,,Aortic hemiarch graft,A,,17.31,3.47,NA,3.47,,4.27,25.05,25.05,0,ZZZ,0.00,0.00,0.00,0,0,0,0,1,9,,33.4009,09,0,99,0.00,0.00,0.00