No office rate
This code describes a composite valve graft with coronary reconstruction. Code 33858 is for ascending aortic replacement for dissection without that combination.
On this page
CMS RVU26D · Effective 2026-10-01
33863 Aortic graft Medicare reimbursement rates in Massachusetts
Reports ascending aortic replacement using a valve-containing composite graft with coronary reconstruction, as in a Bentall operation for aortic root disease. Compare 33863 office and facility rates across CMS payment localities in Massachusetts.
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 33863 in Massachusetts?
Massachusetts has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$2868.15–$3033.12
2 of 2 localities have a supported rate.
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.
Cardiothoracic surgery
About 33863: Ascending aortic replacement with valve conduit
Reports ascending aortic replacement using a valve-containing composite graft with coronary reconstruction, as in a Bentall operation for aortic root disease.
This operation replaces the diseased ascending aorta with a composite conduit that includes a prosthetic aortic valve, then reconnects the coronary arteries to the graft. Cardiac surgeons commonly perform it in a hospital operating room for aortic root or ascending aortic disease when the valve and aorta are addressed together. The operative report should establish the composite valve graft and coronary reconstruction; a simple aortic graft or a valve replacement without this reconstruction describes a different service.
Report the code for the operation documented, including the graft and coronary work; do not separately report the valve replacement that is built into this composite procedure. The 90-day global period includes the day-before preoperative visit and related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this anatomy. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 33863
- 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 RVU57.32 · 66%
- Practice expense (office) RVU15.54 · 18%
- Malpractice RVU14.14 · 16%
3.5K
Medicare services in 2024 · #2083 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.
33863 compared with similar codes
Office rates for Massachusetts, from the same CMS release.
No office rate
Use this code for the composite valve conduit and coronary reconstruction. Code 33859 describes ascending aortic replacement for disease other than dissection without those features.
No office rate
Both codes involve a composite valve graft and coronary reconstruction; code 33864 is distinguished by additional operative features documented in the procedure.
No office rate
This code covers composite valve-graft replacement with coronary reconstruction. Code 33866 is for an operation involving an aortic hemiarch graft.
Compare 33863 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.
2 of 2 payment localities
Metropolitan Boston →
Office / nonfacility
Unavailable
Facility
$3033.12
Rest Of Massachusetts →
Office / nonfacility
Unavailable
Facility
$2868.15
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33863 billing questions
When is this code chosen over an ascending aortic graft without a valve conduit?
Use this code when the operation uses a composite graft that includes a prosthetic valve and reconstructs the coronary connections. A graft replacement without that combined valve-and-coronary work points to a different code.
Can the aortic valve replacement be reported separately?
The valve replacement is part of the composite conduit service. Do not separately report it as an additional valve procedure for the same work.
What operative documentation supports this code?
The report should identify the composite valve-containing graft, the ascending aortic replacement, and coronary reconstruction or reimplantation. It should also describe the operative extent and any additional procedures performed.
Can an assistant or co-surgeon be reported?
CMS permits assistant-at-surgery payment for this service. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How does the global period affect postoperative services?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Should modifier 50 be used for this operation?
No. The anatomy and descriptor make a bilateral adjustment inappropriate.
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.
4,08933853,,Rpr hypopl a-arch w/byp,A,,31.70,12.10,NA,12.10,,7.99,51.79,51.79,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,09033858,,As-aort grf f/aortic dsj,A,,61.82,16.69,NA,16.69,,15.31,93.82,93.82,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,09133859,,As-aort grf f/ds oth/thn dsj,A,,44.00,12.86,NA,12.86,,10.86,67.72,67.72,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,09233863,,Ascending aortic graft,A,,57.32,15.54,NA,15.54,,14.14,87.00,87.00,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,09333864,,Ascending aortic graft,A,,58.58,15.81,NA,15.81,,14.42,88.81,88.81,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,09433866,,Aortic hemiarch graft,A,,17.31,3.47,NA,3.47,,4.27,25.05,25.05,0,ZZZ,0.00,0.00,0.00,0,0,0,0,1,9,,33.4009,09,0,99,0.00,0.00,0.00
4,0953386F,,Ajcc cln cncr stage 2 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