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CMS RVU26D · Effective 2026-10-01

33641 ASD repair Medicare reimbursement rates in Kentucky

Reports open surgical closure of a secundum atrial septal defect using cardiopulmonary bypass, typically during congenital heart surgery. Compare 33641 office and facility rates across CMS payment localities in Kentucky.

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 33641 in Kentucky?

Kentucky 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

$1477.06

1 of 1 localities have a supported rate.

Payment area: Kentucky

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 33641 in your payment locality →

Cardiac surgery

About 33641: Surgical closure of secundum atrial septal defect

Reports open surgical closure of a secundum atrial septal defect using cardiopulmonary bypass, typically during congenital heart surgery.

This service closes a congenital opening between the atria that is identified as a secundum atrial septal defect. A cardiac surgeon performs the repair during open-heart surgery with cardiopulmonary bypass, using direct closure or a patch as indicated by the defect and operative findings. The code is for the secundum form, not other atrial septal defect types or ventricular septal defects.

Report it when the operative record identifies the secundum defect and documents surgical closure with bypass. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate for this repair. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

CMS billing rules for 33641

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 RVU28.84 · 63%
  • Practice expense (office) RVU9.81 · 21%
  • Malpractice RVU7.28 · 16%

2.4K

Medicare services in 2024 · #2324 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.

33641 compared with similar codes

Office rates for Kentucky, from the same CMS release.

33647

Atrial septal repair

Sinus venosus type

No office rate

Use 33641 for a secundum atrial septal defect and 33647 for a primum-type defect. The documented defect type determines the code.

33645

Pulmonary vein repair

Partial or total anomalous return

No office rate

Code 33645 addresses a sinus venosus defect with anomalous pulmonary venous return; 33641 is for a secundum defect.

93580

ASD closure

Transcatheter device closure

No office rate

Code 93580 describes a transcatheter closure approach. Code 33641 describes surgical closure with cardiopulmonary bypass.

33681

VSD closure

One defect, with or without patch

No office rate

Code 33681 closes a ventricular septal defect. Code 33641 repairs a communication between the atria.

Compare 33641 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 33641 in Kentucky.

PPRRVU2026_Oct_nonQPP.csv

4,021

Code
33641
Physician work
28.84
Practice expense
9.81
Malpractice
7.28

GPCI2026.csv

55

Locality
Kentucky
Physician work
1.000
Practice expense
0.889
Malpractice
0.915
Facility calculation for 33641 in Kentucky
ComponentRVULocality factorAdjusted
Physician work28.84× 1.00028.8400
Practice expense9.81× 0.8898.7211
Malpractice7.28× 0.9156.6612
Total RVUs44.2223
Conversion factor× 33.4009

Facility rate, Kentucky$1477.06

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
Work28.841
Practice expense9.810.889
Malpractice7.280.915

(28.84 × 1 + 9.81 × 0.889 + 7.28 × 0.915) × $33.4009 = $1477.06

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.

33641 billing questions

How does this differ from code 33647?

Code 33641 is for surgical closure of a secundum atrial septal defect with bypass. Code 33647 is for a primum-type defect.

What operative documentation supports code 33641?

The operative report should identify the defect as secundum, describe its surgical closure, and document use of cardiopulmonary bypass.

Can modifier 50 be reported?

No. Modifier 50 is inappropriate for this single septal repair.

How does the global period affect postoperative billing?

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

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

When the surgeon performs another procedure in the same session, how is payment adjusted?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction.

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 33641PPRRVU2026_Oct_nonQPP.csv, line 4,021 (RVU26D)
Geographic factors for KentuckyGPCI2026.csv, line 55 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet