No office rate
33362 is the primary TAVR service for open femoral access. Add 33368 when cardiopulmonary bypass is used during that procedure.
On this page
CMS RVU26D · Effective 2026-10-01
33368 TAVR with bypass Medicare reimbursement rates in Missouri
Reports cardiopulmonary bypass support during transcatheter aortic valve replacement performed through an open femoral artery approach. Compare 33368 office and facility rates across CMS payment localities in Missouri.
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 33368 in Missouri?
Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$660.52–$672.31
3 of 3 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.
Where 33368 pays more and less in Missouri
Cardiac surgery
About 33368: TAVR with bypass, open femoral access
Reports cardiopulmonary bypass support during transcatheter aortic valve replacement performed through an open femoral artery approach.
Code 33368 represents cardiopulmonary bypass used during transcatheter aortic valve replacement when the valve is reached through an open femoral artery exposure. The procedure is generally performed by a cardiac surgery team in a hospital operating room for a patient undergoing TAVR who requires bypass support. It is distinct from the TAVR service itself: the open femoral access route and valve replacement are represented by the matching primary procedure code.
Report 33368 only with its qualifying primary TAVR procedure, not as a standalone service. For an open femoral approach, pair it with 33362. The operative report should support the open femoral route and the use of cardiopulmonary bypass during the valve procedure. CMS treats this as an add-on code paid within the primary procedure’s global period, so it does not establish a separate global period.
CMS billing rules for 33368
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU14.03 · 69%
- Practice expense (office) RVU2.88 · 14%
- Malpractice RVU3.35 · 17%
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.
33368 compared with similar codes
Office rates for Missouri, from the same CMS release.
No office rate
Both are TAVR bypass add-ons, but they correspond to different access approaches. Select the code matching the primary TAVR approach.
No office rate
33369 is the bypass add-on for a different TAVR access approach; 33368 corresponds to open femoral access.
No office rate
33361 is the primary TAVR code for percutaneous femoral access, not the open femoral approach represented by the 33362 and 33368 pairing.
Compare 33368 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.
3 of 3 payment localities
Metropolitan Kansas City →
Office / nonfacility
Unavailable
Facility
$668.26
Metropolitan St. Louis →
Office / nonfacility
Unavailable
Facility
$672.31
Rest Of Missouri →
Office / nonfacility
Unavailable
Facility
$660.52
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33368 billing questions
Which primary code is paired with 33368?
For TAVR using an open femoral artery approach, report 33368 with primary code 33362. The primary code describes the TAVR access approach; 33368 accounts for the bypass service.
Can 33368 be reported by itself?
No. It is an add-on code and must be reported with the qualifying primary procedure.
How is 33368 different from 33362?
Code 33362 represents TAVR through open femoral access. Code 33368 is the add-on for cardiopulmonary bypass used during that procedure.
What documentation supports 33368?
The operative record should identify the open femoral access route and document cardiopulmonary bypass use during TAVR.
Does 33368 have its own global period?
No. CMS pays this add-on within the global period of the primary procedure.
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.
3,92733365,,Replace aortic valve open,A,,25.93,5.94,NA,5.94,,6.28,38.15,38.15,0,000,0.00,0.00,0.00,2,0,0,2,1,9,,33.4009,09,0,99,0.00,0.00,0.00
3,92833366,,Trcath replace aortic valve,A,,28.62,6.45,NA,6.45,,6.86,41.93,41.93,0,000,0.00,0.00,0.00,2,0,0,2,1,9,,33.4009,09,0,99,0.00,0.00,0.00
3,92933367,,Replace aortic valve w/byp,A,,11.58,2.38,NA,2.38,,2.76,16.72,16.72,0,ZZZ,0.00,0.00,0.00,0,0,0,0,1,9,,33.4009,09,0,99,0.00,0.00,0.00
3,93033368,,Replace aortic valve w/byp,A,,14.03,2.88,NA,2.88,,3.35,20.26,20.26,0,ZZZ,0.00,0.00,0.00,0,0,0,0,1,9,,33.4009,09,0,99,0.00,0.00,0.00
3,93133369,,Replace aortic valve w/byp,A,,18.53,3.80,NA,3.80,,4.44,26.77,26.77,0,ZZZ,0.00,0.00,0.00,0,0,0,0,1,9,,33.4009,09,0,99,0.00,0.00,0.00
3,93233370,,Tcat plmt&rmvl cepd perq,A,,2.44,0.46,NA,0.46,,0.57,3.47,3.47,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,93333390,,Valvuloplasty aortic valve,A,,34.13,10.62,NA,10.62,,8.31,53.06,53.06,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00