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CMS RVU26D · Effective 2026-10-01

33859 Aortic graft Medicare reimbursement rates in Guam

Open graft replacement of the ascending aorta for aneurysmal or other non-dissection disease, when the operation does not meet a more specific root-replacement description. Compare 33859 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 33859 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

$2168.04

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.

Find 33859 in your payment locality →

Cardiothoracic surgery

About 33859: Ascending aortic graft for non-dissection disease

Open graft replacement of the ascending aorta for aneurysmal or other non-dissection disease, when the operation does not meet a more specific root-replacement description.

A cardiothoracic surgeon uses this code for open graft replacement of the ascending aorta when the underlying condition is not an aortic dissection. A typical case is repair of an ascending aortic aneurysm. These operations are generally performed in an operating room, often with cardiopulmonary bypass. The operative report should establish the treated aortic segment, the non-dissection diagnosis, and the graft replacement performed.

Report this code for the non-dissection ascending-aortic procedure, distinguishing it from dissection repair and from procedures with a more specific aortic-root description. The major-surgery 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 the others at 50%. Modifier 50 is not appropriate for this aortic service. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

CMS billing rules for 33859

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 RVU44.00 · 65%
  • Practice expense (office) RVU12.86 · 19%
  • Malpractice RVU10.86 · 16%

4.8K

Medicare services in 2024 · #1888 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.

33859 compared with similar codes

Office rates for Guam, from the same CMS release.

33858

Aortic graft

Ascending aorta, dissection

No office rate

Choose 33858 for ascending-aortic graft replacement performed for aortic dissection; choose 33859 for a non-dissection condition such as an ascending aneurysm.

33863

Aortic graft

Valve conduit, coronary reconstruction

No office rate

Code 33863 describes ascending-aortic grafting that includes aortic-root replacement and coronary reimplantation, rather than the non-dissection ascending-aortic service described by 33859.

33864

Aortic graft

With root replacement and CABG

No office rate

Code 33864 is for ascending-aortic grafting with aortic-valve suspension. Review the operative details to distinguish that work from the service reported with 33859.

33866

Aortic graft

Hemiarch extension

No office rate

Code 33866 identifies an operation that includes the aortic hemiarch; 33859 is selected when the documented work does not meet that hemiarch description.

Compare 33859 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

Office and facility base rates · shared scale starting at $0

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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 33859 in Hawaii, Guam.

PPRRVU2026_Oct_nonQPP.csv

4,091

Code
33859
Physician work
44.00
Practice expense
12.86
Malpractice
10.86

GPCI2026.csv

46

Locality
Hawaii, Guam
Physician work
1.000
Practice expense
1.137
Malpractice
0.579
Facility calculation for 33859 in Hawaii, Guam
ComponentRVULocality factorAdjusted
Physician work44.00× 1.00044.0000
Practice expense12.86× 1.13714.6218
Malpractice10.86× 0.5796.2879
Total RVUs64.9098
Conversion factor× 33.4009

Facility rate, Hawaii, Guam$2168.04

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.
Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work441
Practice expense12.861.137
Malpractice10.860.579

(44 × 1 + 12.86 × 1.137 + 10.86 × 0.579) × $33.4009 = $2168.04

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.

33859 billing questions

How does this differ from 33858?

Code 33859 is for ascending-aortic graft replacement for disease other than dissection. Code 33858 is the corresponding choice when the indication is aortic dissection.

When should a root-replacement code be considered instead?

Use a root-specific code when the operation includes the aortic-root work described by that code, rather than graft replacement limited to the ascending aorta. The operative report should identify the extent of resection and reconstruction.

Are related postoperative visits included?

The global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

Should modifier 50 be appended for bilateral work?

No. Modifier 50 is not appropriate for this ascending-aortic service.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, with other procedures in the same session paid 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 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.

RVUs for 33859PPRRVU2026_Oct_nonQPP.csv, line 4,091 (RVU26D)
Geographic factors for Hawaii, GuamGPCI2026.csv, line 46 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet