Billing code 33776: Atrial switch repairMedicare rate & RVUs in Florida

Reports transposition of the great arteries repair using an atrial baffle, with closure of a ventricular septal defect during the operation.

CMS RVU26DEffective Oct 1, 20263 payment localities

CMS doesn’t publish an office rate for 33776 in Florida.

—Office (non-facility)
$1,974.36–$2,304.12Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 33776 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Florida
  2. What 33776 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 33776 covers

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.

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.

Where 33776 pays more and less in Florida

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

33776 office and facility rates by payment locality
Payment localityOfficeFacility
Fort LauderdaleUnavailable$2,086.11
MiamiUnavailable$2,304.12
Rest Of FloridaUnavailable$1,974.36

How the 33776 rate is calculated

Each of 33776’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 · 33776

RVUs × geographic indexes × conversion factor

Work33.88

33.88 RVUs× 1.000 GPCI

Practice expense12.95

12.95 RVUs× 1.000 GPCI

Malpractice8.55

8.55 RVUs× 1.000 GPCI

Adjusted RVUs

55.3800

Conversion factor

$33.4009

Medicare rate

$1,849.74

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 33776

33776 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 33776

Atrial switch repair

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.84/0.07Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 33776

Atrial switch repair

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

33776 without 51 · national facility

$1,849.74

Atrial switch repair

33776-51 · Second procedure: 50%

$924.87

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%).

When to use modifier 51

33776 compared with similar codes

Compare codes · National

5 codes, side by side

  • 33776

    Atrial switch repair33.88 wRVU

    Not priced

  • 33774

    Atrial baffle repair30.94 wRVU

    Not priced

  • 33777

    TGA repair33.32 wRVU

    Not priced

  • 33780

    Transposition repair42.8 wRVU

    Not priced

  • 33771

    TGA repair39.61 wRVU

    Not priced

How to choose

33774Atrial baffle repair
Choose 33776 when the atrial baffle operation includes VSD closure. Code 33774 describes an atrial baffle repair without that specified addition.
33777TGA repair
33777 is for an atrial baffle repair that includes repair of subpulmonary obstruction; 33776 specifies VSD closure.
33780Transposition repair
Both include VSD closure in a transposition repair, but 33780 describes an arterial-switch approach rather than an atrial baffle.
33771TGA repair
33771 describes transposition repair with VSD closure and surgical enlargement of the VSD. 33776 identifies an atrial baffle repair with VSD closure.

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 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
RVUs for 33776PPRRVU2026_Oct_nonQPP.csv, line 4,064 (RVU26D)

Open CMS sourceHow we calculate rates

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