Billing code 33778: Arterial switch repairMedicare rate & RVUs in Florida
Reports surgical correction of transposed great arteries by reconstructing the aorta and pulmonary artery, typically during an arterial switch operation.
CMS doesn’t publish an office rate for 33778 in Florida.
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 33778 covers
This open-heart repair corrects transposition of the great arteries by restoring the aorta and pulmonary artery to the appropriate ventricular outflows. The surgeon divides and reconnects the great vessels and reconstructs their roots; coronary artery transfer is part of the usual arterial-switch approach. Congenital cardiac surgeons perform the operation in an operating room, often for infants with dextro-transposition of the great arteries.
Select this code when the documented operation includes the aortic and pulmonary artery reconstruction described by this repair, rather than an atrial-baffle repair or a separately specified reconstruction variant. The operative report should identify the anatomy, repair technique, great-vessel reconstruction, and any associated work such as VSD closure or relief of subpulmonary obstruction. The 90-day global period includes 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 are subject to the standard 50% reduction. Modifier 50 is inappropriate. 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 33778 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.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | Unavailable | $2,480.49 |
| Miami | Unavailable | $2,746.36 |
| Rest Of Florida | Unavailable | $2,347.83 |
How the 33778 rate is calculated
Each of 33778’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 · 33778
RVUs × geographic indexes × conversion factor
Work41.68
41.68 RVUs× 1.000 GPCI
Practice expense13.39
13.39 RVUs× 1.000 GPCI
Malpractice10.52
10.52 RVUs× 1.000 GPCI
Adjusted RVUs
65.5900
Conversion factor
$33.4009
Medicare rate
$2,190.77
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33778
33778 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33778
Arterial switch repair
| 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 · 33778
Arterial 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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
33778 without 51 · national facility
$2,190.77
Arterial switch repair
33778-51 · Second procedure: 50%
$1,095.39
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%).
33778 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 33779Arterial switch repair
- Use 33779 when the transposition reconstruction also includes removal of a pulmonary artery band, as documented in the operative report.
- 33780Transposition repair
- Use 33780 for the reconstruction variant that includes VSD closure; 33778 describes the great-vessel reconstruction without that specified variant.
- 33781Transposition repair
- Use 33781 when the reconstruction includes repair of subpulmonary obstruction, rather than the reconstruction represented by 33778 alone.
- 33774Atrial baffle repair
- Code 33774 represents an atrial-baffle repair. Code 33778 represents a great-vessel reconstruction approach.
33778 billing questions
How is this code distinguished from an atrial-baffle repair?
This code describes great-vessel reconstruction in an arterial-switch-type repair. Code 33774 describes an atrial-baffle approach, which redirects blood flow within the atria rather than switching the great arteries.
Which code applies when the repair also closes a VSD?
Compare the operative details with 33780, the reconstruction variant identifying VSD closure. The report should establish the actual repair and associated work rather than relying on the diagnosis alone.
Is modifier 50 appropriate for this repair?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this operation.
How does the multiple-procedure reduction affect same-session surgery?
When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction.
What supports assistant or co-surgeon reporting?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What postoperative care is included in the global period?
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 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
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