No office rate
33858 reports an ascending aortic replacement primary operation; 33866 captures additional hemiarch graft reconstruction when performed with an eligible primary procedure.
On this page
CMS RVU26D · Effective 2026-10-01
33866 Aortic graft Medicare reimbursement rates in Delaware
Reports graft reconstruction of the aortic hemiarch added to an eligible ascending aortic replacement during open repair of complex aortic disease. Compare 33866 office and facility rates across CMS payment localities in Delaware.
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 33866 in Delaware?
Delaware has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$823.79
1 of 1 localities have a supported rate.
Payment area: Delaware
One mapped payment locality.
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.
Cardiothoracic surgery
About 33866: Aortic hemiarch graft reconstruction
Reports graft reconstruction of the aortic hemiarch added to an eligible ascending aortic replacement during open repair of complex aortic disease.
This add-on describes reconstruction of the proximal aortic arch’s hemiarch segment as part of an open aortic operation. The cardiac surgeon replaces the diseased portion with graft material, often while treating aneurysmal or other complex disease that also requires ascending aortic replacement. These procedures are typically performed in a hospital operating room with cardiopulmonary bypass; the operative report should identify the hemiarch work and the extent of aortic replacement performed.
Report 33866 with an eligible primary ascending aortic replacement, such as 33858, 33859, 33863, or 33864; it is not a stand-alone service. Documentation should distinguish hemiarch reconstruction from replacement limited to the ascending aorta and describe the grafted segment. CMS treats this as an add-on code billed with the primary procedure, with payment within that procedure’s global period.
CMS billing rules for 33866
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU17.31 · 69%
- Practice expense (office) RVU3.47 · 14%
- Malpractice RVU4.27 · 17%
2.2K
Medicare services in 2024 · #2399 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.
33866 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
33863 identifies an ascending aortic and root replacement using a composite graft. Add 33866 when the operative work also includes hemiarch reconstruction.
No office rate
33871 describes replacement of the transverse arch. Code 33866 is for a hemiarch graft added to an eligible ascending aortic replacement.
Compare 33866 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.
1 of 1 payment localities
Delaware →
Office / nonfacility
Unavailable
Facility
$823.79
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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 33866 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
4,094
- Code
- 33866
- Physician work
- 17.31
- Practice expense
- 3.47
- Malpractice
- 4.27
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 17.31 | × 1.005 | 17.3965 |
| Practice expense | 3.47 | × 0.988 | 3.4284 |
| Malpractice | 4.27 | × 0.899 | 3.8387 |
| Total RVUs | 24.6636 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$823.79
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 17.31 | 1.005 |
| Practice expense | 3.47 | 0.988 |
| Malpractice | 4.27 | 0.899 |
(17.31 × 1.005 + 3.47 × 0.988 + 4.27 × 0.899) × $33.4009 = $823.79
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.
33866 billing questions
Which primary codes can be paired with 33866?
It is reported as an add-on with eligible ascending aortic replacement procedures, including 33858, 33859, 33863, and 33864. The operative report must support that hemiarch reconstruction was performed.
Can 33866 be reported by itself?
No. CMS identifies it as an add-on code, so it must be billed with a primary procedure and is paid within that procedure’s global period.
How is hemiarch reconstruction distinguished from an ascending aortic graft?
The documentation should show that the graft reconstruction extended into the hemiarch, rather than being limited to the ascending aorta. The primary code identifies the associated ascending aortic operation.
When is a broader arch replacement code more appropriate?
When the operative work replaces the transverse aortic arch rather than a hemiarch segment, compare the documented extent with code 33871. The code selection should follow the actual arch reconstruction performed.
What should the operative report document?
It should describe the diseased aortic segments treated, the hemiarch graft reconstruction, and the associated primary ascending aortic replacement. This supports reporting the add-on with the operation that required it.
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.
4,09133859,,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
4,09733875,,Thoracic aortic graft,A,,49.45,14.17,NA,14.17,,12.33,75.95,75.95,0,090,0.09,0.84,0.07,2,0,2,2,0,9,,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