Billing code 33641: ASD repairMedicare rate & RVUs in Nebraska
Reports open surgical closure of a secundum atrial septal defect using cardiopulmonary bypass, typically during congenital heart surgery.
CMS doesn’t publish an office rate for 33641 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 33641 covers
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.
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 in Nebraska
| Payment locality | Office | Facility |
|---|---|---|
| Nebraska | Unavailable | $1,357.63 |
How the 33641 rate is calculated
Each of 33641’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 · 33641
RVUs × geographic indexes × conversion factor
Work28.84
28.84 RVUs× 1.000 GPCI
Practice expense9.81
9.81 RVUs× 1.000 GPCI
Malpractice7.28
7.28 RVUs× 1.000 GPCI
Adjusted RVUs
45.9300
Conversion factor
$33.4009
Medicare rate
$1,534.10
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33641
33641 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33641
ASD 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 · 33641
ASD 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
33641 without 51 · national facility
$1,534.10
ASD repair
33641-51 · Second procedure: 50%
$767.05
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%).
33641 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 33647Atrial septal repair
- Use 33641 for a secundum atrial septal defect and 33647 for a primum-type defect. The documented defect type determines the code.
- 33645Pulmonary vein repair
- Code 33645 addresses a sinus venosus defect with anomalous pulmonary venous return; 33641 is for a secundum defect.
- 93580ASD closure
- Code 93580 describes a transcatheter closure approach. Code 33641 describes surgical closure with cardiopulmonary bypass.
- 33681VSD closure
- Code 33681 closes a ventricular septal defect. Code 33641 repairs a communication between the atria.
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 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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