Billing code 33405: Aortic valve replacementMedicare rate & RVUs in Nebraska
Reports open surgical replacement of a diseased aortic valve using a conventional prosthesis, such as a mechanical or stented tissue valve.
CMS doesn’t publish an office rate for 33405 in Nebraska.
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 33405 covers
A cardiac surgeon removes the diseased aortic valve and implants a prosthesis during open surgery, typically using cardiopulmonary bypass. Common indications include severe aortic stenosis or regurgitation requiring surgical replacement. The implanted valve may be mechanical or a stented tissue prosthesis; this code distinguishes those options from a homograft or stentless tissue valve. These operations are performed in a hospital operating room, and CMS recorded 18,664 facility services for the code in 2024.
Report the code when the operative record supports open aortic valve replacement and identifies the implanted prosthesis sufficiently to distinguish it from the valve types represented by neighboring codes. The 90-day global period includes 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. An assistant at surgery 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.
33405 in Nebraska
| Payment locality | Office | Facility |
|---|---|---|
| Nebraska | Unavailable | $1,884.22 |
How the 33405 rate is calculated
Each of 33405’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 · 33405
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 40.29Practice expense 13.38Malpractice 9.98
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 33405
33405 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33405
Aortic valve replacement
| 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 · 33405
Aortic valve replacement
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
33405 without 51 · national facility
$2,125.97
Aortic valve replacement
33405-51 · Second procedure: 50%
$1,062.99
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%).
33405 compared with similar codes
Compare codes
33405 vs 33406 vs 33410 vs 33411 vs 33414: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 33406Aortic valve replacement
- Choose 33406 when the replacement uses a homograft. Code 33405 represents a conventional prosthesis, such as a mechanical or stented tissue valve.
- 33410Aortic valve replacement
- Choose 33410 when a stentless tissue valve is implanted; 33405 is for a prosthesis other than a homograft or stentless tissue valve.
- 33411Aortic valve replacement
- 33411 describes aortic valve replacement with annular enlargement. Use 33405 when the operation does not include that enlargement procedure.
- 33414Aortic valve repair
- 33414 is for repair of the aortic valve. Use 33405 when the surgeon removes the diseased valve and implants a prosthesis.
33405 billing questions
When is 33405 selected instead of 33406 or 33410?
Use 33405 for a conventional prosthesis, such as a mechanical or stented tissue valve. The neighboring codes distinguish homograft and stentless tissue valve procedures.
What operative documentation supports 33405?
The operative report should establish open replacement of the aortic valve and identify the implanted valve type. This supports selecting the code rather than one for a homograft or stentless tissue valve.
How does the global period affect postoperative reporting?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures from the same session paid?
The highest-valued procedure is paid in full; other procedures performed in the same session are subject to the standard multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
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
Fee sheets
Put 33405 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →