No office rate
33320 describes major-vessel repair without cardiopulmonary bypass. Choose 33322 when the repair involves bypass and hypothermic circulatory arrest.
On this page
CMS RVU26D · Effective 2026-10-01
33322 Vessel repair Medicare reimbursement rates in Guam
Reports major blood vessel repair performed with cardiopulmonary bypass and hypothermic circulatory arrest, such as complex repair involving the aorta. Compare 33322 office and facility rates across CMS payment localities in Guam.
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 33322 in Guam?
Guam 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
$1290.86
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
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 33322: Major vessel repair with circulatory arrest
Reports major blood vessel repair performed with cardiopulmonary bypass and hypothermic circulatory arrest, such as complex repair involving the aorta.
This service covers operative repair of a major blood vessel while the patient is supported by cardiopulmonary bypass and placed in hypothermic circulatory arrest. It may involve direct closure or patch repair; complex aortic arch repair is a typical setting. Cardiothoracic surgeons perform the procedure in an operating room, generally in a hospital facility.
Select this code when the operative record supports major-vessel repair and documents hypothermic circulatory arrest, rather than repair using bypass without arrest or repair without bypass. The report should identify the vessel, the repair performed, and the use of bypass and circulatory arrest. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 33322
- 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 RVU23.81 · 60%
- Practice expense (office) RVU10.03 · 25%
- Malpractice RVU5.93 · 15%
117
Medicare services in 2024 · #4757 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.
33322 compared with similar codes
Office rates for Guam, from the same CMS release.
No office rate
33321 describes major-vessel repair with cardiopulmonary bypass but without hypothermic circulatory arrest. The arrest documented in the operative record distinguishes 33322.
No office rate
33330 is for insertion of a major-vessel graft. Use 33322 when the service is repair of the vessel with hypothermic circulatory arrest, rather than graft insertion.
Compare 33322 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
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$1290.86
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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 33322 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
3,919
- Code
- 33322
- Physician work
- 23.81
- Practice expense
- 10.03
- Malpractice
- 5.93
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 23.81 | × 1.000 | 23.8100 |
| Practice expense | 10.03 | × 1.137 | 11.4041 |
| Malpractice | 5.93 | × 0.579 | 3.4335 |
| Total RVUs | 38.6476 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$1290.86
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 23.81 | 1 |
| Practice expense | 10.03 | 1.137 |
| Malpractice | 5.93 | 0.579 |
(23.81 × 1 + 10.03 × 1.137 + 5.93 × 0.579) × $33.4009 = $1290.86
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.
33322 billing questions
How is this code distinguished from 33321?
Use 33322 when the major-vessel repair includes hypothermic circulatory arrest. Code 33321 describes repair with cardiopulmonary bypass without that distinguishing circumstance.
What should the operative report document?
Document the vessel repaired, the repair performed, and use of cardiopulmonary bypass and hypothermic circulatory arrest. These details distinguish the service from other major-vessel repair codes.
Can an assistant surgeon be reported?
CMS indicates that assistant-at-surgery payment may be made for this service. Co-surgeon payment requires supporting documentation.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
How are other procedures from the same session paid?
Under the standard multiple procedure rule, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction.
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.
3,9163331F,,Bk imaging tst not ordered,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
3,91733320,,Repair major blood vessel(s),A,,18.08,7.83,NA,7.83,,4.55,30.46,30.46,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,91833321,,Repair major vessel,A,,20.29,9.10,NA,9.10,,4.86,34.25,34.25,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,91933322,,Repair major blood vessel(s),A,,23.81,10.03,NA,10.03,,5.93,39.77,39.77,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,92033330,,Insert major vessel graft,A,,24.66,10.25,NA,10.25,,5.91,40.82,40.82,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,92133335,,Insert major vessel graft,A,,33.06,11.97,NA,11.97,,7.93,52.96,52.96,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,92233340,,Perq clsr tcat l atr apndge,A,,9.99,6.18,NA,6.18,,2.35,18.52,18.52,0,000,0.00,0.00,0.00,2,0,0,2,1,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014