Billing code 33362: Aortic valve replacementMedicare rate & RVUs in Guam
Report 33362 when a prosthetic aortic valve is delivered by catheter through a femoral artery that has been surgically exposed.
CMS doesn’t publish an office rate for 33362 in Guam.
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 33362 covers
This procedure replaces the aortic valve using a catheter introduced through a surgically exposed femoral artery. It is an option for a patient undergoing transcatheter treatment of aortic stenosis when open femoral access is used rather than a needle puncture through the skin. An interventional cardiologist and cardiac surgeon may work together in a catheterization laboratory or hybrid operating room. The valve is delivered through the femoral access site and positioned within the diseased aortic valve; the surgical opening is the access route, not an open surgical replacement of the valve.
Select 33362 from the documented route of access, specifically a femoral artery exposed by incision. Document the access method and valve implantation. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures at 50%. Modifier 50 is inappropriate for this valve procedure. An assistant surgeon requires documentation of medical necessity; co-surgeons are permitted, while team surgery requires supporting documentation.
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.
33362 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $1,119.18 |
How the 33362 rate is calculated
Each of 33362’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 · 33362
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 23.93Practice expense 5.48Malpractice 5.78
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 33362
The CMS indicators that decide how 33362 is paid alongside other services.
CMS payment indicators · 33362
Aortic valve replacement
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 2 | Permitted. |
| Team surgery (66) | 1 | Permitted with supporting documentation. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
33362 without 51 · national facility
$1,175.38
Aortic valve replacement
33362-51 · Second procedure: 50%
$587.69
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%).
33362 compared with similar codes
Compare codes
33362 vs 33361 vs 33363 vs 33364: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 33361TAVR
- Both use the femoral route for transcatheter valve delivery. Choose 33362 for surgical exposure of the femoral artery and 33361 for percutaneous access.
- 33363TAVR
- Choose 33363 when the valve is delivered through an apical approach. Code 33362 requires surgically exposed femoral arterial access.
- 33364TAVR
- Choose 33364 for an aortic access approach. Code 33362 describes catheter delivery through a surgically exposed femoral artery.
33362 billing questions
When is 33362 used instead of 33361?
Use 33362 when the femoral artery is surgically exposed for valve delivery. Use 33361 when femoral access is percutaneous.
Does an open femoral incision make this an open surgical valve replacement?
No. In 33362, the incision provides arterial access; the prosthetic valve is delivered and implanted by catheter.
Is same-day postoperative care separately reported?
CMS assigns 33362 a 0-day global period that includes same-day preoperative and postoperative care.
Can modifier 50 be used for femoral access?
No. The bilateral adjustment is inappropriate for this aortic valve procedure, even though femoral arteries exist on both sides.
How does CMS treat multiple procedures and additional surgeons?
In the same session, the highest-valued procedure is paid in full and other procedures at 50%. An assistant surgeon requires documentation of medical necessity; co-surgeons are permitted, and team surgery requires supporting documentation.
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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