No office rate
Both involve division of an aberrant vessel, but 33803 also requires reanastomosis. Check the operative report for the completed vascular connection.
On this page
CMS RVU26D · Effective 2026-10-01
33803 Aberrant vessel repair Medicare reimbursement rates in Hawaii
Reports surgical division of an aberrant vessel followed by reconnection when reconstruction is needed to relieve compression while maintaining blood flow. Compare 33803 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 33803 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
$1052.15
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.
Cardiovascular surgery
About 33803: Aberrant vessel division with reanastomosis
Reports surgical division of an aberrant vessel followed by reconnection when reconstruction is needed to relieve compression while maintaining blood flow.
This operation addresses an abnormally positioned vessel that compresses the airway or esophagus. A cardiovascular surgeon divides the vessel and reconnects it so blood can continue to reach the territory it supplies. It may be performed for a symptomatic vascular ring, including one involving an aberrant subclavian artery. The operative report should identify the vessel, the structures it compresses, and where the divided vessel was reconnected.
Report 33803 when division and reanastomosis are both performed; division without reconnection is distinguished by 33802. CMS assigns this major surgery a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. If other procedures are performed in the same session, the highest-valued procedure is paid in full and additional procedures are subject to a 50% multiple-procedure reduction. Modifier 50 is inappropriate for this anatomy. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation. Team surgery is not permitted.
CMS billing rules for 33803
- 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 RVU19.80 · 61%
- Practice expense (office) RVU7.76 · 24%
- Malpractice RVU4.97 · 15%
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.
33803 compared with similar codes
Office rates for Hawaii, from the same CMS release.
No office rate
Aortic suspension repositions the aorta to relieve compression. Code 33803 requires division and reanastomosis of an aberrant vessel.
No office rate
Code 33820 is for ligation of a patent ductus arteriosus. Use 33803 when the documented operation divides and reconnects an aberrant vessel.
Compare 33803 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
$1052.15
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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 33803 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
4,077
- Code
- 33803
- Physician work
- 19.80
- Practice expense
- 7.76
- Malpractice
- 4.97
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 19.80 | × 1.000 | 19.8000 |
| Practice expense | 7.76 | × 1.137 | 8.8231 |
| Malpractice | 4.97 | × 0.579 | 2.8776 |
| Total RVUs | 31.5008 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$1052.15
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 19.8 | 1 |
| Practice expense | 7.76 | 1.137 |
| Malpractice | 4.97 | 0.579 |
(19.8 × 1 + 7.76 × 1.137 + 4.97 × 0.579) × $33.4009 = $1052.15
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.
33803 billing questions
When is 33803 reported instead of 33802?
Use 33803 when the aberrant vessel is divided and reanastomosed. Code 33802 describes division without that reconnection.
What operative details support 33803?
The report should identify the aberrant vessel and document both its division and the completed reanastomosis. Documentation of division alone supports consideration of 33802 instead.
Can modifier 50 be reported for this repair?
No. CMS specifies that the bilateral adjustment is inappropriate for this procedure’s anatomy or descriptor.
How are an assistant and co-surgeons treated?
CMS allows payment for an assistant at surgery. Co-surgeon payment requires supporting documentation, while team surgery is not permitted.
What care is included in the global period?
The 90-day global period 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.
4,0743378F,,Ajcc brstcncr stage 3 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
4,07533800,,Aortic suspension,A,,16.85,6.94,NA,6.94,,4.24,28.03,28.03,0,090,0.09,0.84,0.07,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,07633802,,Division aberrant vessel,A,,17.91,8.88,NA,8.88,,4.51,31.30,31.30,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,07733803,,Div aberrant vsl w/reanast,A,,19.80,7.76,NA,7.76,,4.97,32.53,32.53,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,0783380F,,Ajcc brstcncr stage 4 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
4,07933814,,Obltrj a-pulm sep def w/byp,A,,25.91,10.96,NA,10.96,,6.53,43.40,43.40,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,08033820,,Repair pda by ligation,A,,16.27,7.34,NA,7.34,,4.09,27.70,27.70,0,090,0.09,0.84,0.07,2,0,2,0,0,9,,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