No office rate
Both include ascending aortic root replacement with a valved conduit and coronary reconstruction. Select 33864 when CABG is also performed; 33863 is the corresponding root procedure without that CABG distinction.
On this page
CMS RVU26D · Effective 2026-10-01
33864 Aortic graft Medicare reimbursement rates in California
Reports ascending aortic replacement with a valved root conduit, coronary reconstruction, and coronary artery bypass grafting during the same operation. Compare 33864 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 33864 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
$2826.81–$3191.49
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $364.68 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 33864 pays more and less in California
Cardiothoracic surgery
About 33864: Ascending aortic root graft with bypass
Reports ascending aortic replacement with a valved root conduit, coronary reconstruction, and coronary artery bypass grafting during the same operation.
This code describes replacement of the ascending aorta and aortic root with a valved conduit, reconstruction of the coronary arteries, and coronary artery bypass grafting during the same operation. Cardiac surgeons typically perform this open procedure in a hospital operating room, often using cardiopulmonary bypass. A Bentall-type root replacement is a familiar example; coronary reimplantation into the conduit is distinct from bypass grafting to a diseased coronary artery.
Choose this code when the operative report supports the root conduit, coronary reconstruction, and CABG combination. Document the aortic and root work, the coronary reconstruction, and the bypass grafting performed. The 90-day global period includes 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. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 33864
- 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 RVU58.58 · 66%
- Practice expense (office) RVU15.81 · 18%
- Malpractice RVU14.42 · 16%
532
Medicare services in 2024 · #3500 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.
33864 compared with similar codes
Office rates for California, from the same CMS release.
No office rate
This code covers ascending aortic replacement for aortic disease other than dissection without root replacement using a valved conduit. It does not represent the combined root-and-CABG operation.
No office rate
This code covers ascending aortic replacement for dissection without root replacement using a valved conduit. Use 33864 for the root conduit, coronary reconstruction, and CABG combination.
Compare 33864 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 $2865.88 |
| Chico | Office Unavailable | Facility $2826.81 |
| El Centro | Office Unavailable | Facility $2829.22 |
| Fresno | Office Unavailable | Facility $2826.81 |
| Hanford-Corcoran | Office Unavailable | Facility $2826.81 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $2981.36 |
| Madera | Office Unavailable | Facility $2826.81 |
| Merced | Office Unavailable | Facility $2826.81 |
| Modesto | Office Unavailable | Facility $2826.81 |
| Napa | Office Unavailable | Facility $3020.56 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $2935.65 |
| Redding | Office Unavailable | Facility $2826.81 |
| Rest Of California | Office Unavailable | Facility $2826.81 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $2981.45 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $2899.37 |
| Salinas | Office Unavailable | Facility $2887.47 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $2907.94 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $3108.15 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $3091.78 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $3191.49 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $3124.54 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $2849.52 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $2897.48 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $2885.30 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $2921.95 |
| Stockton | Office Unavailable | Facility $2826.81 |
| Vallejo | Office Unavailable | Facility $2996.96 |
| Visalia | Office Unavailable | Facility $2826.81 |
| Yuba City | Office Unavailable | Facility $2826.81 |
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33864 billing questions
How does this differ from 33863?
Both describe ascending aortic root replacement using a valved conduit with coronary reconstruction. Use 33864 when coronary artery bypass grafting is also performed as part of the operation; 33863 describes the root procedure without that CABG distinction.
Does coronary reimplantation count as CABG?
No. Reimplanting the coronary ostia into the conduit is coronary reconstruction, not bypass grafting. The operative report must support actual CABG for this code's added distinction.
What supports reporting this code?
The operative report should document replacement of the ascending aorta and root with a valved conduit, coronary reconstruction, and coronary artery bypass grafting.
Can modifier 50 be reported?
No. The anatomy and procedure do not support a bilateral adjustment.
How are assistant and co-surgeon services handled?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
4,09033858,,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
4,0953386F,,Ajcc cln cncr stage 2 docd,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4,09633871,,Transvrs a-arch grf hypthrm,A,,59.36,15.84,NA,15.84,,14.72,89.92,89.92,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00