No office rate
Both address double-outlet right ventricle. Choose 33612 when the operation also repairs pulmonary stenosis, with or without conduit placement.
On this page
CMS RVU26D · Effective 2026-10-01
33611 Congenital heart repair Medicare reimbursement rates in Pennsylvania
Reports surgical reconstruction of double-outlet right ventricle by creating an intracardiac pathway that directs left ventricular blood toward the aorta. Compare 33611 office and facility rates across CMS payment localities in Pennsylvania.
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 33611 in Pennsylvania?
Pennsylvania has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1770.27–$1908.54
2 of 2 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.
Cardiac surgery
About 33611: Double-outlet right ventricle tunnel repair
Reports surgical reconstruction of double-outlet right ventricle by creating an intracardiac pathway that directs left ventricular blood toward the aorta.
A congenital cardiac surgeon uses this code for repair of double-outlet right ventricle by constructing an intracardiac tunnel, or baffle, that routes blood from the left ventricle through the ventricular septal defect to the aorta. The operation is performed in a hospital operating room and involves complex reconstruction of the heart’s internal blood flow. It is not the code for an isolated ventricular septal defect closure.
Report the code when the operative work documents this double-outlet right ventricle repair, rather than selecting it solely because a patient has the diagnosis. The code has a 90-day global period: the day-before preoperative visit and related postoperative care during that period are included. 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. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 33611
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU34.68 · 64%
- Practice expense (office) RVU10.96 · 20%
- Malpractice RVU8.74 · 16%
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.
33611 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
33611 describes intracardiac tunnel reconstruction for double-outlet right ventricle; 33608 is for a congenital anomaly repair involving a conduit.
No office rate
Use 33622 for a complex redo congenital cardiac anomaly repair, rather than the specific double-outlet right ventricle tunnel repair described by 33611.
Compare 33611 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.
2 of 2 payment localities
Metropolitan Philadelphia →
Office / nonfacility
Unavailable
Facility
$1908.54
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$1770.27
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33611 billing questions
How do I distinguish 33611 from 33612?
Code 33611 for the double-outlet right ventricle repair using an intracardiac tunnel. Code 33612 when the operation also includes repair of pulmonary stenosis, with or without conduit placement.
Can an isolated ventricular septal defect closure be reported as 33611?
No. This code describes reconstruction for double-outlet right ventricle, not an isolated VSD closure.
How does the multiple-procedure reduction affect another procedure in the same session?
The highest-valued procedure is paid in full; other procedures performed in that session are subject to the standard 50% reduction.
Can modifier 50 be used for this repair?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
What documentation supports reporting 33611?
The operative report should identify double-outlet right ventricle and describe construction of the intracardiac tunnel routing left ventricular blood toward the aorta.
How are assistant and co-surgeon claims handled?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; 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 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.
4,01033606,,Anastomosis/artery-aorta,A,,30.74,11.74,NA,11.74,,7.74,50.22,50.22,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,01133608,,Repair anomaly w/conduit,A,,31.08,11.98,NA,11.98,,7.84,50.90,50.90,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,01233610,,Repair by enlargement,A,,30.62,11.88,NA,11.88,,7.72,50.22,50.22,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,01333611,,Repair double ventricle,A,,34.68,10.96,NA,10.96,,8.74,54.38,54.38,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,01433612,,Repair double ventricle,A,,35.66,11.15,NA,11.15,,9.00,55.81,55.81,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,01533615,,Repair modified fontan,A,,34.99,12.25,NA,12.25,,8.82,56.06,56.06,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,01633617,,Repair single ventricle,A,,38.11,12.86,NA,12.86,,9.62,60.59,60.59,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00