Billing code 33858: Aortic graftMedicare rate & RVUs in Ohio
Reports graft replacement of the ascending aorta for dissection, including operations performed with or without cardiopulmonary bypass.
CMS doesn’t publish an office rate for 33858 in Ohio.
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 33858 covers
Code 33858 describes open replacement of the ascending thoracic aorta with a graft to treat aortic dissection, commonly an acute dissection involving the ascending segment. Cardiothoracic surgeons perform this major operation in a hospital operating room. Cardiopulmonary bypass may be used, but its use does not change the code. The procedure addresses the dissected ascending aorta, rather than disease confined to another aortic segment.
Report the code when the operative report supports graft replacement of the ascending aorta specifically for dissection. Documentation should identify the dissection, the segment treated, and the graft replacement performed; distinguish this service from code 33859, for ascending-aortic graft replacement for other disease. The CMS 90-day global includes the day-before preoperative visit and related postoperative care during the following 90 days. For multiple procedures in the same session, the highest-valued procedure is paid in full and others are subject to the standard 50% 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.
33858 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $3,089.26 |
How the 33858 rate is calculated
Each of 33858’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 · 33858
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 61.82Practice expense 16.69Malpractice 15.31
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 33858
33858 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33858
Aortic graft
| 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 · 33858
Aortic graft
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
33858 without 51 · national facility
$3,133.67
Aortic graft
33858-51 · Second procedure: 50%
$1,566.84
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%).
33858 compared with similar codes
Compare codes
33858 vs 33859 vs 33863 vs 33866: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 33859Aortic graft
- Both describe ascending-aortic graft replacement. Choose 33858 when the indication is aortic dissection; 33859 applies to other disease.
- 33863Aortic graft
- Compare the operative work with the full descriptor for 33863, which identifies additional operative elements; 33858 is selected for graft replacement specifically for dissection.
- 33866Aortic graft
- Code 33866 describes aortic hemiarch graft work. Use 33858 for ascending-aortic graft replacement for dissection when the reported work is not the hemiarch service described by 33866.
33858 billing questions
When should 33858 be used instead of 33859?
Use 33858 when the ascending aorta is replaced with a graft for dissection. Code 33859 is for ascending-aortic graft replacement for other disease, such as an aneurysm without dissection.
Does cardiopulmonary bypass determine whether 33858 applies?
No. Code 33858 covers ascending-aortic graft replacement for dissection with or without cardiopulmonary bypass.
What postoperative care is included in the global period?
The 90-day global includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only with supporting documentation; team surgery is not permitted.
How does the multiple-procedure reduction affect another procedure performed in the same session?
The highest-valued procedure is paid in full, and other procedures performed in the same session are subject to the standard 50% 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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