Billing code 33665: AV canal repairMedicare rate & RVUs in Illinois
Reports surgical repair of an intermediate or transitional atrioventricular septal defect, with or without repair of the left atrioventricular valve cleft.
CMS doesn’t publish an office rate for 33665 in Illinois.
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 33665 covers
This code describes open surgical correction of an intermediate or transitional atrioventricular septal defect, often called an AV canal defect. The anatomy includes an atrial septal component and a limited ventricular septal component at the atrioventricular junction. A congenital cardiac surgeon repairs the defect; the operation may also include repair of the left atrioventricular valve cleft. These procedures are performed in a cardiac operating room, typically as major congenital heart surgery.
Select this code from the documented defect type and operative anatomy, not simply from the fact that septal tissue was closed. The operative report should support the intermediate or transitional form and describe the repair performed, including any valve work. The day-before preoperative visit and 90 days of related postoperative care are included in the 90-day global period. For other procedures in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
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.
Where 33665 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $2,163.81 |
| East St. Louis | Unavailable | $2,044.62 |
| Rest Of Illinois | Unavailable | $1,912.84 |
| Suburban Chicago | Unavailable | $2,021.88 |
How the 33665 rate is calculated
Each of 33665’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 · 33665
RVUs × geographic indexes × conversion factor
Work33.98
33.98 RVUs× 1.000 GPCI
Practice expense10.82
10.82 RVUs× 1.000 GPCI
Malpractice8.58
8.58 RVUs× 1.000 GPCI
Adjusted RVUs
53.3800
Conversion factor
$33.4009
Medicare rate
$1,782.94
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33665
33665 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33665
AV canal repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.84/0.07 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 33665
AV canal repair
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
33665 without 51 · national facility
$1,782.94
AV canal repair
33665-51 · Second procedure: 50%
$891.47
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%).
33665 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 33660AV canal repair
- Use 33660 for a partial atrioventricular septal defect. Use 33665 when the documented defect is intermediate or transitional.
- 33670Canal repair
- 33670 describes repair of a complete atrioventricular septal defect, rather than the intermediate or transitional form reported with 33665.
- 33641ASD repair
- 33641 is for atrial septal defect repair. It does not describe repair of the combined atrioventricular septal anatomy represented by 33665.
- 33681VSD closure
- 33681 describes closure of one ventricular septal defect. 33665 is selected for repair of an intermediate or transitional atrioventricular septal defect.
33665 billing questions
How is this code distinguished from 33660?
33665 is for an intermediate or transitional atrioventricular septal defect. 33660 describes repair of a partial atrioventricular septal defect; use the documented anatomy to select the code.
When would 33670 be reported instead?
33670 is for repair of a complete atrioventricular septal defect. The operative diagnosis and described anatomy should establish whether the defect is complete or intermediate/transitional.
Is repair of the valve cleft included in the service?
The code accommodates repair of the left atrioventricular valve cleft as part of the AV septal defect operation. The operative report should describe any valve repair performed.
Can modifier 50 be used?
No. Bilateral adjustment is inappropriate for this code and anatomy.
How are assistant and co-surgeon services handled?
Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation, while team surgery is not permitted.
What postoperative care is included?
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 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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