No office rate
Choose 33776 when the atrial baffle operation includes VSD closure. Code 33774 describes an atrial baffle repair without that specified addition.
On this page
CMS RVU26D · Effective 2026-10-01
33776 Atrial switch repair Medicare reimbursement rates in California
Reports transposition of the great arteries repair using an atrial baffle, with closure of a ventricular septal defect during the operation. Compare 33776 office and facility rates across CMS payment localities in California.
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 33776 in California?
California has 29 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 29 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1778.00–$2032.90
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $254.90 per service.
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 33776 pays more and less in California
Congenital heart surgery
About 33776: Transposition repair with atrial baffle and VSD closure
Reports transposition of the great arteries repair using an atrial baffle, with closure of a ventricular septal defect during the operation.
This code describes an atrial-switch repair for transposition of the great arteries that includes closing a ventricular septal defect (VSD). The operation redirects systemic and pulmonary venous blood at the atrial level with a baffle and closes the VSD as part of the repair. Congenital cardiac surgeons typically perform it in an operating room, often for a patient with complex congenital heart disease.
Report the code when the operative record supports both the atrial baffle repair and VSD closure. The closure is part of this combined service. Medicare assigns a 90-day global period, including 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 other procedures at 50%. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 33776
- 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 RVU33.88 · 61%
- Practice expense (office) RVU12.95 · 23%
- Malpractice RVU8.55 · 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.
33776 compared with similar codes
Office rates for California, from the same CMS release.
No office rate
33777 is for an atrial baffle repair that includes repair of subpulmonary obstruction; 33776 specifies VSD closure.
No office rate
Both include VSD closure in a transposition repair, but 33780 describes an arterial-switch approach rather than an atrial baffle.
No office rate
33771 describes transposition repair with VSD closure and surgical enlargement of the VSD. 33776 identifies an atrial baffle repair with VSD closure.
Compare 33776 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.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield | Office Unavailable | Facility $1801.11 |
| Chico | Office Unavailable | Facility $1778.00 |
| El Centro | Office Unavailable | Facility $1779.42 |
| Fresno | Office Unavailable | Facility $1778.00 |
| Hanford-Corcoran | Office Unavailable | Facility $1778.00 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $1879.34 |
| Madera | Office Unavailable | Facility $1778.00 |
| Merced | Office Unavailable | Facility $1778.00 |
| Modesto | Office Unavailable | Facility $1778.00 |
| Napa | Office Unavailable | Facility $1918.08 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $1852.49 |
| Redding | Office Unavailable | Facility $1778.00 |
| Rest Of California | Office Unavailable | Facility $1778.00 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $1869.66 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $1828.48 |
| Salinas | Office Unavailable | Facility $1821.09 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $1837.67 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $1980.09 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $1970.38 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $2032.90 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $1993.20 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $1796.59 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $1833.99 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $1820.72 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $1849.80 |
| Stockton | Office Unavailable | Facility $1778.00 |
| Vallejo | Office Unavailable | Facility $1904.08 |
| Visalia | Office Unavailable | Facility $1778.00 |
| Yuba City | Office Unavailable | Facility $1778.00 |
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33776 billing questions
How does this differ from 33774?
Both involve an atrial baffle repair for transposition. Use 33776 when the operation also includes VSD closure; 33774 describes the atrial baffle procedure without that specified addition.
Is VSD closure separately reported with 33776?
VSD closure is included in this combined procedure. The operative report should document the closure as part of the atrial-switch repair.
How does 33776 differ from 33777?
33776 includes VSD closure. 33777 identifies an atrial baffle repair that includes repair of subpulmonary obstruction.
Can modifier 50 be appended?
No. The anatomy and procedure represented by 33776 make modifier 50 inappropriate.
What global period applies?
Medicare assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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.
4,06133771,,Rpr tga w/surg enlgmnt vsd,A,,39.61,10.39,NA,10.39,,10.02,60.02,60.02,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,06233774,,Rpr tga atrial baffle px,A,,30.94,12.25,NA,12.25,,7.81,51.00,51.00,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,06333775,,Rpr tga atr bfl rmvl plm bnd,A,,32.17,12.02,NA,12.02,,8.11,52.30,52.30,0,090,0.09,0.84,0.07,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,06433776,,Rpr tga atr bfl clsr vsd,A,,33.88,12.95,NA,12.95,,8.55,55.38,55.38,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,06533777,,Rpr tga bfl rpr sbpulm obstr,A,,33.32,11.21,NA,11.21,,8.39,52.92,52.92,0,090,0.09,0.84,0.07,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,06633778,,Rpr tga aortic pulm art rcns,A,,41.68,13.39,NA,13.39,,10.52,65.59,65.59,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,06733779,,Rpr tga rcnstj rmvl plm bnd,A,,42.15,11.37,NA,11.37,,10.64,64.16,64.16,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00