Billing code 33415: Subaortic resectionMedicare rate & RVUs in Nevada

Open-heart resection of obstructing tissue beneath the aortic valve treats discrete subaortic stenosis and is performed with cardiopulmonary bypass.

CMS RVU26DEffective Oct 1, 20261 payment locality109 Medicare services in 2024

CMS doesn’t publish an office rate for 33415 in Nevada.

—Office (non-facility)
$1,854.37Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 33415 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Nevada
  2. What 33415 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 33415 covers

This operation removes tissue beneath the aortic valve that creates a discrete obstruction to blood leaving the left ventricle. A cardiac surgeon performs it through an open-heart approach with cardiopulmonary bypass. The service can include septal muscle removal when needed as part of treating the subaortic obstruction. It is distinct from an operation directed at repairing or replacing the aortic valve itself.

Report 33415 when the operative target is subvalvular tissue causing discrete subaortic stenosis. The operative report should identify the obstructing tissue and describe its resection and use of bypass. CMS assigns 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 50% multiple-procedure reduction. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation. Team surgery payment 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.

33415 in Nevada**

33415 office and facility rates by payment locality
Payment localityOfficeFacility
Nevada**Unavailable$1,854.37

How the 33415 rate is calculated

Each of 33415’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 · 33415

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 36.34Practice expense 11.67Malpractice 9.00

57.0100 adjusted RVUs×$33.4009 conversion factor=$1,904.19

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 33415

33415 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 33415

Subaortic resection

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.84/0.07Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 33415

Subaortic resection

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

33415 without 51 · national facility

$1,904.19

Subaortic resection

33415-51 · Second procedure: 50%

$952.10

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%).

When to use modifier 51

33415 compared with similar codes

Compare codes

33415 vs 33416 vs 33414 vs 33405: national Medicare rates

Swap in your local Medicare rate.

  • 33415
    Subaortic resection · 36.34 wRVU
    —
  • 33416
    Septal myectomy · 35.65 wRVU
    —
  • 33414
    Aortic valve repair · 38.39 wRVU
    —
  • 33405
    Aortic valve replacement · 40.29 wRVU
    —

How to choose

33416Septal myectomy
33415 treats discrete obstructing tissue below the aortic valve. 33416 targets ventricular septal muscle in hypertrophic subaortic obstruction.
33414Aortic valve repair
33414 is directed at repairing the aortic valve itself; 33415 removes obstructing tissue below the valve.
33405Aortic valve replacement
33405 replaces the aortic valve. 33415 treats subvalvular obstruction without describing valve replacement.

33415 billing questions

How do I distinguish 33415 from 33416?

Use 33415 for removal of discrete obstructing tissue beneath the aortic valve. Code 33416 describes ventricular septal muscle resection for hypertrophic subaortic obstruction.

Does 33415 include myectomy?

The service may include myectomy when it is part of resecting tissue for discrete subaortic stenosis. The operative report should show the subvalvular obstruction being treated.

Is aortic valve repair or replacement included?

33415 addresses tissue below the valve, not repair or replacement of the valve. A separate valve procedure may be reported when independently performed for coexisting valve disease.

What postoperative care is included?

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

How are multiple procedures in the same session paid?

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

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery payment 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
RVUs for 33415PPRRVU2026_Oct_nonQPP.csv, line 3,944 (RVU26D)
Geographic factors for Nevada**GPCI2026.csv, line 73 (RVU26D)

Open CMS sourceHow we calculate rates

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