No office rate
Choose 33406 for a homograft or stentless valve. Choose 33405 for a prosthetic valve that is neither of those types.
On this page
CMS RVU26D · Effective 2026-10-01
33406 Aortic valve replacement Medicare reimbursement rates in Hawaii
Open replacement of a diseased aortic valve using a homograft or stentless valve, reported when the operative record supports that implant type. Compare 33406 office and facility rates across CMS payment localities in Hawaii.
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 33406 in Hawaii?
Hawaii 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
$2569.75
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.
Cardiac surgery
About 33406: Open aortic valve homograft or stentless replacement
Open replacement of a diseased aortic valve using a homograft or stentless valve, reported when the operative record supports that implant type.
Code 33406 represents open aortic valve replacement performed with cardiopulmonary bypass using a homograft or stentless valve. A cardiac surgeon removes the diseased native valve and implants the selected replacement during major heart surgery, typically in a hospital operating room. The implanted valve type—not simply the diagnosis or the fact that the valve is biologic—distinguishes this service from other aortic valve replacement coding.
Report the code when the operative record supports open replacement, cardiopulmonary bypass, and use of a homograft or stentless valve. The procedure has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. CMS may pay an assistant at surgery; co-surgeon payment requires supporting documentation, and team surgery payment is not permitted. Modifier 50 is inappropriate for this code.
CMS billing rules for 33406
- 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 RVU51.36 · 64%
- Practice expense (office) RVU15.89 · 20%
- Malpractice RVU12.97 · 16%
29
Medicare services in 2024 · #5685 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.
33406 compared with similar codes
Office rates for Hawaii, from the same CMS release.
No office rate
33440 describes the Ross procedure, which uses the patient's pulmonary valve in the aortic position and replaces the pulmonary valve. It is not a single-valve homograft or stentless replacement.
No office rate
33414 is an aortic valve repair code. Use 33406 when the operation replaces the valve with a homograft or stentless valve.
Compare 33406 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
$2569.75
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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 33406 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
3,937
- Code
- 33406
- Physician work
- 51.36
- Practice expense
- 15.89
- Malpractice
- 12.97
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 51.36 | × 1.000 | 51.3600 |
| Practice expense | 15.89 | × 1.137 | 18.0669 |
| Malpractice | 12.97 | × 0.579 | 7.5096 |
| Total RVUs | 76.9366 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$2569.75
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 51.36 | 1 |
| Practice expense | 15.89 | 1.137 |
| Malpractice | 12.97 | 0.579 |
(51.36 × 1 + 15.89 × 1.137 + 12.97 × 0.579) × $33.4009 = $2569.75
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.
33406 billing questions
How is 33406 different from 33405?
33406 applies when the operative record identifies a homograft or stentless valve. Code 33405 is for a prosthetic valve other than those types.
Is cardiopulmonary bypass included?
Yes. The code describes open aortic valve replacement performed with cardiopulmonary bypass.
Can another procedure be reported during the same operation?
A separately reportable procedure may be subject to the standard multiple procedure reduction when performed in the same session. The operative documentation must support each reported service.
Which modifiers or surgical assistance rules should the biller consider?
Modifier 50 is inappropriate. CMS may pay an assistant at surgery, while co-surgeon payment requires supporting documentation; team surgery payment is not permitted.
What care is included in the global period?
The 90-day global 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 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.
3,93433391,,Valvuloplasty aortic valve,A,,40.46,13.28,NA,13.28,,9.71,63.45,63.45,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,93533404,,Prepare heart-aorta conduit,A,,30.59,11.92,NA,11.92,,7.33,49.84,49.84,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,93633405,,Replacement aortic valve opn,A,,40.29,13.38,NA,13.38,,9.98,63.65,63.65,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,93733406,,Replacement aortic valve opn,A,,51.36,15.89,NA,15.89,,12.97,80.22,80.22,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,9383340F,,Mammo assess inc xray docd,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
3,93933410,,Replacement aortic valve opn,A,,45.25,14.84,NA,14.84,,11.28,71.37,71.37,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,94033411,,Replacement of aortic valve,A,,60.52,17.88,NA,17.88,,14.94,93.34,93.34,0,090,0.09,0.84,0.07,2,0,2,0,0,9,,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