Billing code 33404: Conduit preparationMedicare rate & RVUs in Alabama
Reports the surgeon’s preparation of the heart-aorta conduit to receive an aortic valve homograft during open aortic valve surgery.
CMS doesn’t publish an office rate for 33404 in Alabama.
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 9 sections
What 33404 covers
This service covers preparing the recipient heart and aortic outflow tract for an aortic valve homograft during open cardiac surgery. A cardiac surgeon performs the work, typically in an operating room with cardiopulmonary bypass as part of a valve replacement operation. The preparation is distinct from the act of implanting the replacement valve; the operative report should make clear what conduit preparation was performed and how it relates to the valve procedure.
Report the code when the documented operation includes this specific preparation, not simply because a homograft is implanted. Identify the graft type, the relevant anatomy, and the preparation performed. The procedure has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. 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. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation. 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.
33404 in Alabama
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Unavailable | $1,508.68 |
How the 33404 rate is calculated
Each of 33404’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 · 33404
RVUs × geographic indexes × conversion factor
Work30.59
30.59 RVUs× 1.000 GPCI
Practice expense11.92
11.92 RVUs× 1.000 GPCI
Malpractice7.33
7.33 RVUs× 1.000 GPCI
Adjusted RVUs
49.8400
Conversion factor
$33.4009
Medicare rate
$1,664.70
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33404
33404 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33404
Conduit preparation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.84/0.07 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 33404
Conduit preparation
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
33404 without 51 · national facility
$1,664.70
Conduit preparation
33404-51 · Second procedure: 50%
$832.35
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%).
33404 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 33406Aortic valve replacement
- 33406 describes aortic valve replacement using a homograft. This code describes preparation of the recipient conduit, which may be performed during that replacement operation.
- 33405Aortic valve replacement
- 33405 describes replacement with a prosthetic valve. This code concerns conduit preparation for a homograft rather than prosthetic valve implantation.
- 33410Aortic valve replacement
- 33410 describes aortic valve replacement using the patient’s pulmonary valve. This code concerns preparation of the heart-aorta conduit for homograft insertion.
33404 billing questions
How does this differ from the aortic valve replacement code?
This code represents preparation of the recipient heart-aorta conduit. A separate replacement code describes the valve replacement itself; the operative report should support each reported service.
When is this reported with an aortic homograft replacement?
Report it when the surgeon performs the specified conduit preparation during the operation. Document the preparation separately from the act of implanting the homograft.
Does the code have a 90-day global period?
Yes. The global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are multiple procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
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 used?
No. Bilateral adjustment does not apply to this code.
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
Fee sheets
Put 33404 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →