No office rate
Choose 33416 for resection of hypertrophied ventricular muscle. Choose 33415 for excision of a subaortic membrane.
On this page
CMS RVU26D · Effective 2026-10-01
33416 Septal myectomy Medicare reimbursement rates in Hawaii
Reports surgical removal of hypertrophied ventricular muscle, typically to relieve left ventricular outflow obstruction in obstructive hypertrophic cardiomyopathy. Compare 33416 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 33416 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
$1836.20
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 33416: Ventricular septal myectomy
Reports surgical removal of hypertrophied ventricular muscle, typically to relieve left ventricular outflow obstruction in obstructive hypertrophic cardiomyopathy.
A cardiac surgeon removes a portion of thickened ventricular septal muscle to widen the left ventricular outflow tract, most often for obstructive hypertrophic cardiomyopathy. The operation is commonly performed through the aortic valve, with or without cardiopulmonary bypass. It is a facility-based major cardiac procedure, not a catheter-based septal reduction treatment.
Report the code when the operative record supports actual ventricular muscle resection; a subaortic membrane excision alone is a different service. Documentation should identify the obstructive condition, the muscle resected, and any separately performed valve procedure. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate for this ventricular procedure. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 33416
- 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 RVU35.65 · 63%
- Practice expense (office) RVU12.53 · 22%
- Malpractice RVU8.77 · 15%
808
Medicare services in 2024 · #3139 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.
33416 compared with similar codes
Office rates for Hawaii, from the same CMS release.
No office rate
33425 represents mitral valve repair, not ventricular muscle resection. It may be reported with 33416 when both distinct operations are performed.
No office rate
33405 represents open aortic valve replacement. It is not a substitute for septal muscle resection, though both may be performed when separately indicated.
Compare 33416 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
$1836.20
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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 33416 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
3,945
- Code
- 33416
- Physician work
- 35.65
- Practice expense
- 12.53
- Malpractice
- 8.77
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 35.65 | × 1.000 | 35.6500 |
| Practice expense | 12.53 | × 1.137 | 14.2466 |
| Malpractice | 8.77 | × 0.579 | 5.0778 |
| Total RVUs | 54.9744 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$1836.20
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 35.65 | 1 |
| Practice expense | 12.53 | 1.137 |
| Malpractice | 8.77 | 0.579 |
(35.65 × 1 + 12.53 × 1.137 + 8.77 × 0.579) × $33.4009 = $1836.20
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.
33416 billing questions
How is 33416 different from 33415?
33416 represents removal of hypertrophied ventricular muscle, commonly for obstructive hypertrophic cardiomyopathy. Use 33415 when the operation excises a subaortic membrane rather than ventricular muscle.
Can 33416 be reported with a valve procedure?
It may be reported with a separately performed valve operation when both procedures are supported by the operative record. CMS applies the standard multiple-procedure reduction when multiple procedures are performed in the same session.
Does the code include cardiopulmonary bypass?
The myectomy may be performed with or without cardiopulmonary bypass. The bypass approach does not change the muscle-resection service represented by 33416.
What documentation supports reporting 33416?
Document the obstructive condition, the ventricular muscle resected, and the operative work performed. If a membrane or valve procedure was also performed, describe that distinct work separately.
Can modifier 50 be used?
No. The ventricular anatomy and procedure do not support bilateral reporting with modifier 50.
How are assistant and co-surgeon services handled?
Assistant-at-surgery payment may be made for this procedure. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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.
3,94233413,,Replacement of aortic valve,A,,58.37,17.90,NA,17.90,,14.00,90.27,90.27,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,94333414,,Repair of aortic valve,A,,38.39,11.69,NA,11.69,,9.70,59.78,59.78,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,94433415,,Revision subvalvular tissue,A,,36.34,11.67,NA,11.67,,9.00,57.01,57.01,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,94533416,,Revise ventricle muscle,A,,35.65,12.53,NA,12.53,,8.77,56.95,56.95,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,94633417,,Repair of aortic valve,A,,28.60,11.49,NA,11.49,,7.22,47.31,47.31,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,94733418,,Repair tcat mitral valve,A,,31.44,8.46,NA,8.46,,7.43,47.33,47.33,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,94833419,,Repair tcat mitral valve,A,,7.73,1.47,NA,1.47,,1.82,11.02,11.02,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,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