Billing code 33440: Aortic valve replacementMedicare rate & RVUs in Georgia
Report this code for open aortic valve replacement using the patient’s pulmonary valve as an autograft, with reconstruction of the pulmonary valve position.
CMS doesn’t publish an office rate for 33440 in Georgia.
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 33440 covers
The Ross procedure replaces a diseased aortic valve by moving the patient’s own pulmonary valve into the aortic position. The surgeon then reconstructs the pulmonary valve position, commonly with a donor pulmonary valve or conduit. Cardiothoracic surgeons perform this open operation in a hospital operating room, typically for patients who need aortic valve replacement and are candidates for use of their own pulmonary valve tissue.
Select this code when the operative report documents the pulmonary autograft’s translocation to the aortic position, rather than replacement with a prosthetic valve or an allograft. Documentation should identify the valve procedure and describe the pulmonary valve reconstruction. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. For other procedures performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Report the single valve operation without modifier 50. An assistant may be paid; 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 33440 pays more and less in Georgia
| Payment locality | Office | Facility |
|---|---|---|
| Atlanta | Unavailable | $3,284.23 |
| Rest Of Georgia | Unavailable | $3,201.12 |
How the 33440 rate is calculated
Each of 33440’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 · 33440
RVUs × geographic indexes × conversion factor
Work62.40
62.40 RVUs× 1.000 GPCI
Practice expense17.47
17.47 RVUs× 1.000 GPCI
Malpractice14.98
14.98 RVUs× 1.000 GPCI
Adjusted RVUs
94.8500
Conversion factor
$33.4009
Medicare rate
$3,168.08
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33440
33440 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33440
Aortic valve replacement
| 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 · 33440
Aortic valve replacement
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
33440 without 51 · national facility
$3,168.08
Aortic valve replacement
33440-51 · Second procedure: 50%
$1,584.04
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%).
33440 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 33405Aortic valve replacement
- Use 33405 for aortic valve replacement with a prosthetic valve. Use 33440 when the pulmonary valve is moved into the aortic position as an autograft.
- 33406Aortic valve replacement
- Code 33406 describes aortic valve replacement with an allograft. Code 33440 describes translocation of the patient’s pulmonary valve.
- 33414Aortic valve repair
- Code 33414 is for aortic valve repair; 33440 is for replacement through the Ross procedure.
33440 billing questions
How is this different from a standard prosthetic aortic valve replacement?
This code is for a Ross procedure: the patient’s pulmonary valve is moved to the aortic position. A prosthetic valve replacement uses a valve prosthesis instead.
Is the pulmonary valve reconstruction part of this operation?
Yes. Reconstruction of the pulmonary valve position is part of the Ross procedure; the operative report should describe how that position was reconstructed.
Should modifier 50 be reported?
No. Report the single aortic valve operation without modifier 50; the procedure is not a bilateral service.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
How does the 90-day global period affect postoperative billing?
The global period includes the day-before preoperative visit and 90 days of related postoperative care. For other procedures in the same session, the highest-valued procedure is paid in full and the others at 50%.
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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