No office rate
Use 33641 for a secundum atrial septal defect and 33647 for a primum-type defect. The documented defect type determines the code.
On this page
CMS RVU26D · Effective 2026-10-01
33641 in Delaware
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$1510.43
Base rate per service
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.
Cardiac surgery
About 33641: Surgical closure of secundum atrial septal defect
Reports open surgical closure of a secundum atrial septal defect using cardiopulmonary bypass, typically during congenital heart surgery.
This service closes a congenital opening between the atria that is identified as a secundum atrial septal defect. A cardiac surgeon performs the repair during open-heart surgery with cardiopulmonary bypass, using direct closure or a patch as indicated by the defect and operative findings. The code is for the secundum form, not other atrial septal defect types or ventricular septal defects.
Report it when the operative record identifies the secundum defect and documents surgical closure with bypass. The code has a 90-day global period, including the day-before preoperative visit 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 other procedures are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate for this repair. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 33641
- 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 RVU28.84 · 63%
- Practice expense (office) RVU9.81 · 21%
- Malpractice RVU7.28 · 16%
2.4K
Medicare services in 2024 · #2324 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.
33641 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
Code 33645 addresses a sinus venosus defect with anomalous pulmonary venous return; 33641 is for a secundum defect.
No office rate
Code 93580 describes a transcatheter closure approach. Code 33641 describes surgical closure with cardiopulmonary bypass.
No office rate
Code 33681 closes a ventricular septal defect. Code 33641 repairs a communication between the atria.
The same code, a different location
How does Delaware compare?
33641 across payment areas
Same release and payment basis · bars start at $0
Delaware · This locality
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in Delaware appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Alabama
Alabama · 33641
Office
Unavailable
Facility
$1387.61
No comparable office rate is available.
Arkansas
Arkansas · 33641
Office
Unavailable
Facility
$1369.97
No comparable office rate is available.
Arizona
Arizona · 33641
Office
Unavailable
Facility
$1488.93
No comparable office rate is available.
Bakersfield
California · 33641
Office
Unavailable
Facility
$1488.79
No comparable office rate is available.
Chico
California · 33641
Office
Unavailable
Facility
$1469.11
No comparable office rate is available.
El Centro
California · 33641
Office
Unavailable
Facility
$1470.32
No comparable office rate is available.
Fresno
California · 33641
Office
Unavailable
Facility
$1469.11
No comparable office rate is available.
Hanford-Corcoran
California · 33641
Office
Unavailable
Facility
$1469.11
No comparable office rate is available.
Madera
California · 33641
Office
Unavailable
Facility
$1469.11
No comparable office rate is available.
Merced
California · 33641
Office
Unavailable
Facility
$1469.11
No comparable office rate is available.
Modesto
California · 33641
Office
Unavailable
Facility
$1469.11
No comparable office rate is available.
Napa
California · 33641
Office
Unavailable
Facility
$1579.35
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 33641
Office
Unavailable
Facility
$1529.04
No comparable office rate is available.
Redding
California · 33641
Office
Unavailable
Facility
$1469.11
No comparable office rate is available.
Rest Of California
California · 33641
Office
Unavailable
Facility
$1469.11
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 33641
Office
Unavailable
Facility
$1547.15
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 33641
Office
Unavailable
Facility
$1509.36
No comparable office rate is available.
Salinas
California · 33641
Office
Unavailable
Facility
$1503.24
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 33641
Office
Unavailable
Facility
$1515.86
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 33641
Office
Unavailable
Facility
$1628.41
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 33641
Office
Unavailable
Facility
$1620.14
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 33641
Office
Unavailable
Facility
$1672.07
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 33641
Office
Unavailable
Facility
$1638.27
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 33641
Office
Unavailable
Facility
$1483.20
No comparable office rate is available.
Santa Cruz-Watsonville
California · 33641
Office
Unavailable
Facility
$1511.95
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 33641
Office
Unavailable
Facility
$1502.64
No comparable office rate is available.
Santa Rosa-Petaluma
California · 33641
Office
Unavailable
Facility
$1524.88
No comparable office rate is available.
Stockton
California · 33641
Office
Unavailable
Facility
$1469.11
No comparable office rate is available.
Vallejo
California · 33641
Office
Unavailable
Facility
$1567.44
No comparable office rate is available.
Visalia
California · 33641
Office
Unavailable
Facility
$1469.11
No comparable office rate is available.
Yuba City
California · 33641
Office
Unavailable
Facility
$1469.11
No comparable office rate is available.
Colorado
Colorado · 33641
Office
Unavailable
Facility
$1513.38
No comparable office rate is available.
Connecticut
Connecticut · 33641
Office
Unavailable
Facility
$1629.66
No comparable office rate is available.
Fort Lauderdale
Florida · 33641
Office
Unavailable
Facility
$1734.84
No comparable office rate is available.
Rest Of Florida
Florida · 33641
Office
Unavailable
Facility
$1641.99
No comparable office rate is available.
Atlanta
Georgia · 33641
Office
Unavailable
Facility
$1591.11
No comparable office rate is available.
Rest Of Georgia
Georgia · 33641
Office
Unavailable
Facility
$1545.40
No comparable office rate is available.
Hawaii, Guam
Hawaii · 33641
Office
Unavailable
Facility
$1476.62
No comparable office rate is available.
Iowa
Iowa · 33641
Office
Unavailable
Facility
$1359.63
No comparable office rate is available.
Idaho
Idaho · 33641
Office
Unavailable
Facility
$1379.75
No comparable office rate is available.
East St. Louis
Illinois · 33641
Office
Unavailable
Facility
$1754.45
No comparable office rate is available.
Rest Of Illinois
Illinois · 33641
Office
Unavailable
Facility
$1642.49
No comparable office rate is available.
Suburban Chicago
Illinois · 33641
Office
Unavailable
Facility
$1737.41
No comparable office rate is available.
Indiana
Indiana · 33641
Office
Unavailable
Facility
$1385.20
No comparable office rate is available.
Kansas
Kansas · 33641
Office
Unavailable
Facility
$1382.04
No comparable office rate is available.
Kentucky
Kentucky · 33641
Office
Unavailable
Facility
$1477.06
No comparable office rate is available.
New Orleans
Louisiana · 33641
Office
Unavailable
Facility
$1547.84
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 33641
Office
Unavailable
Facility
$1486.21
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 33641
Office
Unavailable
Facility
$1610.42
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 33641
Office
Unavailable
Facility
$1517.52
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 33641
Office
Unavailable
Facility
$1631.06
No comparable office rate is available.
Rest Of Maryland
Maryland · 33641
Office
Unavailable
Facility
$1527.73
No comparable office rate is available.
Rest Of Maine
Maine · 33641
Office
Unavailable
Facility
$1415.98
No comparable office rate is available.
Southern Maine
Maine · 33641
Office
Unavailable
Facility
$1441.43
No comparable office rate is available.
Detroit
Michigan · 33641
Office
Unavailable
Facility
$1689.44
No comparable office rate is available.
Rest Of Michigan
Michigan · 33641
Office
Unavailable
Facility
$1536.96
No comparable office rate is available.
Minnesota
Minnesota · 33641
Office
Unavailable
Facility
$1372.42
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 33641
Office
Unavailable
Facility
$1508.52
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 33641
Office
Unavailable
Facility
$1518.86
No comparable office rate is available.
Rest Of Missouri
Missouri · 33641
Office
Unavailable
Facility
$1482.56
No comparable office rate is available.
Mississippi
Mississippi · 33641
Office
Unavailable
Facility
$1425.09
No comparable office rate is available.
Montana**
Montana · 33641
Office
Unavailable
Facility
$1533.62
No comparable office rate is available.
North Carolina
North Carolina · 33641
Office
Unavailable
Facility
$1424.37
No comparable office rate is available.
North Dakota**
North Dakota · 33641
Office
Unavailable
Facility
$1389.67
No comparable office rate is available.
Nebraska
Nebraska · 33641
Office
Unavailable
Facility
$1357.63
No comparable office rate is available.
New Hampshire
New Hampshire · 33641
Office
Unavailable
Facility
$1517.14
No comparable office rate is available.
Northern Nj
New Jersey · 33641
Office
Unavailable
Facility
$1663.75
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 33641
Office
Unavailable
Facility
$1626.37
No comparable office rate is available.
New Mexico
New Mexico · 33641
Office
Unavailable
Facility
$1555.78
No comparable office rate is available.
Nevada**
Nevada · 33641
Office
Unavailable
Facility
$1493.82
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 33641
Office
Unavailable
Facility
$1866.07
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 33641
Office
Unavailable
Facility
$1659.64
No comparable office rate is available.
Queens
New York · 33641
Office
Unavailable
Facility
$1762.86
No comparable office rate is available.
Rest Of New York
New York · 33641
Office
Unavailable
Facility
$1445.50
No comparable office rate is available.
Ohio
Ohio · 33641
Office
Unavailable
Facility
$1507.54
No comparable office rate is available.
Oklahoma
Oklahoma · 33641
Office
Unavailable
Facility
$1444.82
No comparable office rate is available.
Portland
Oregon · 33641
Office
Unavailable
Facility
$1523.64
No comparable office rate is available.
Rest Of Oregon
Oregon · 33641
Office
Unavailable
Facility
$1460.57
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 33641
Office
Unavailable
Facility
$1611.81
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 33641
Office
Unavailable
Facility
$1493.86
No comparable office rate is available.
Puerto Rico
Puerto Rico · 33641
Office
Unavailable
Facility
$1534.06
No comparable office rate is available.
Rhode Island
Rhode Island · 33641
Office
Unavailable
Facility
$1536.96
No comparable office rate is available.
South Carolina
South Carolina · 33641
Office
Unavailable
Facility
$1472.73
No comparable office rate is available.
South Dakota**
South Dakota · 33641
Office
Unavailable
Facility
$1372.65
No comparable office rate is available.
Tennessee
Tennessee · 33641
Office
Unavailable
Facility
$1391.70
No comparable office rate is available.
Austin
Texas · 33641
Office
Unavailable
Facility
$1527.31
No comparable office rate is available.
Beaumont
Texas · 33641
Office
Unavailable
Facility
$1487.35
No comparable office rate is available.
Brazoria
Texas · 33641
Office
Unavailable
Facility
$1485.37
No comparable office rate is available.
Dallas
Texas · 33641
Office
Unavailable
Facility
$1506.93
No comparable office rate is available.
Fort Worth
Texas · 33641
Office
Unavailable
Facility
$1506.82
No comparable office rate is available.
Galveston
Texas · 33641
Office
Unavailable
Facility
$1497.69
No comparable office rate is available.
Houston
Texas · 33641
Office
Unavailable
Facility
$1630.94
No comparable office rate is available.
Rest Of Texas
Texas · 33641
Office
Unavailable
Facility
$1493.81
No comparable office rate is available.
Utah
Utah · 33641
Office
Unavailable
Facility
$1489.64
No comparable office rate is available.
Virginia
Virginia · 33641
Office
Unavailable
Facility
$1457.04
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 33641
Office
Unavailable
Facility
$1534.06
No comparable office rate is available.
Vermont
Vermont · 33641
Office
Unavailable
Facility
$1410.71
No comparable office rate is available.
Rest Of Washington
Washington · 33641
Office
Unavailable
Facility
$1505.88
No comparable office rate is available.
Seattle (King Cnty)
Washington · 33641
Office
Unavailable
Facility
$1612.15
No comparable office rate is available.
Wisconsin
Wisconsin · 33641
Office
Unavailable
Facility
$1352.08
No comparable office rate is available.
West Virginia
West Virginia · 33641
Office
Unavailable
Facility
$1595.98
No comparable office rate is available.
Wyoming**
Wyoming · 33641
Office
Unavailable
Facility
$1470.88
No comparable office rate is available.
See how rates vary across the country
33641 · 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 |
Where does this rate apply?
Delaware is a Medicare payment area. Our Census mapping connects it to 79 cities and communities in Delaware, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 33641 in Delaware. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$1661.47
$1510.43 × 110% = $1661.47
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 33641 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
4,021
- Code
- 33641
- Physician work
- 28.84
- Practice expense
- 9.81
- Malpractice
- 7.28
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 28.84 | × 1.005 | 28.9842 |
| Practice expense | 9.81 | × 0.988 | 9.6923 |
| Malpractice | 7.28 | × 0.899 | 6.5447 |
| Total RVUs | 45.2212 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$1510.43
Open 33641 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 28.84 | 1.005 |
| Practice expense | 9.81 | 0.988 |
| Malpractice | 7.28 | 0.899 |
(28.84 × 1.005 + 9.81 × 0.988 + 7.28 × 0.899) × $33.4009 = $1510.43
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
33641 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $1510.43 | RVU26D |
| 2026-07-01 | Not available in this setting | $1510.43 | RVU26C |
| 2026-04-01 | Not available in this setting | $1510.43 | RVU26B |
| 2026-01-01 | Not available in this setting | $1510.43 | RVU26A |
| 2025-10-01 | Not available in this setting | $1560.51 | RVU25D |
| 2025-07-01 | Not available in this setting | $1560.51 | RVU25C |
| 2025-04-01 | Not available in this setting | $1560.51 | RVU25B |
| 2025-01-01 | Not available in this setting | $1560.51 | RVU25A |
33641 billing questions
How does this differ from code 33647?
Code 33641 is for surgical closure of a secundum atrial septal defect with bypass. Code 33647 is for a primum-type defect.
What operative documentation supports code 33641?
The operative report should identify the defect as secundum, describe its surgical closure, and document use of cardiopulmonary bypass.
Can modifier 50 be reported?
No. Modifier 50 is inappropriate for this single septal repair.
How does the global period affect postoperative billing?
The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
When the surgeon performs another procedure in the same session, how is payment adjusted?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure 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.
4,01833620,,Apply r&l pulm art bands,A,,29.25,9.40,NA,9.40,,7.38,46.03,46.03,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,01933621,,Transthor cath for stent,A,,15.78,6.75,NA,6.75,,3.97,26.50,26.50,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,02033622,,Redo compl cardiac anomaly,A,,62.40,16.44,NA,16.44,,15.74,94.58,94.58,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,02133641,,Repair heart septum defect,A,,28.84,9.81,NA,9.81,,7.28,45.93,45.93,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,02233645,,Revision of heart veins,A,,30.52,10.24,NA,10.24,,7.69,48.45,48.45,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,02333647,,Repair heart septum defects,A,,32.18,10.46,NA,10.46,,8.11,50.75,50.75,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,02433660,,Repair of heart defects,A,,31.03,10.25,NA,10.25,,7.83,49.11,49.11,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503