No office rate
33608 identifies a congenital repair using a conduit. This code is for a complex repeat operation after prior cardiac surgery, not simply for conduit use.
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CMS RVU26D · Effective 2026-10-01
33622 Congenital heart surgery Medicare reimbursement rates in Pennsylvania
Reports repeat open surgery for a complex congenital heart defect, such as tetralogy of Fallot or transposition of the great arteries, using cardiopulmonary bypass. Compare 33622 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 33622 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
$3085.11–$3320.55
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 33622: Redo complex congenital heart surgery
Reports repeat open surgery for a complex congenital heart defect, such as tetralogy of Fallot or transposition of the great arteries, using cardiopulmonary bypass.
This code represents a repeat open operation for complex congenital heart disease requiring cardiopulmonary bypass. Examples include reoperation for tetralogy of Fallot, transposition of the great arteries, or double-outlet right ventricle. A congenital cardiac surgeon typically performs the operation in a hospital operating room; patients may be children or adults with congenital heart disease who need further surgical correction after an earlier procedure.
Select the code when the operative record supports both a prior cardiac operation and a complex redo procedure, rather than a first-time repair or a separately defined operation. Documentation should identify the congenital anatomy, prior repair, current surgical work, and use of bypass. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 33622
- 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 RVU62.40 · 66%
- Practice expense (office) RVU16.44 · 17%
- Malpractice RVU15.74 · 17%
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.
33622 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
33611 describes a defined double-outlet right ventricle repair. Choose this code when the service is a complex redo operation that meets its criteria.
No office rate
33615 is specific to a Fontan procedure. This code describes a complex reoperation and is not selected merely because the patient has single-ventricle physiology.
Compare 33622 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
$3320.55
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$3085.11
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33622 billing questions
When should this code be selected instead of a code for a specific congenital repair?
Use it for a complex redo operation after prior cardiac surgery when the procedure fits this service. A code for a defined repair, such as a double-outlet right ventricle repair, may be more appropriate when that specific operation is performed.
What documentation supports reporting a redo procedure?
The operative report should establish the prior cardiac operation, the complex congenital anatomy, the current surgical work, and use of cardiopulmonary bypass.
How is this code affected when other procedures are performed in the same session?
The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard multiple-procedure reduction.
Can modifier 50 be used?
No. The anatomy and service are not coded as bilateral, so modifier 50 is inappropriate.
How are assistant and co-surgeon services handled?
Assistant-at-surgery payment may be made. 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.
4,01733619,,Repair single ventricle,A,,47.54,17.60,NA,17.60,,12.00,77.14,77.14,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,01833620,,Apply r&l pulm art bands,A,,29.25,9.40,NA,9.40,,7.38,46.03,46.03,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,01933621,,Transthor cath for stent,A,,15.78,6.75,NA,6.75,,3.97,26.50,26.50,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,02033622,,Redo compl cardiac anomaly,A,,62.40,16.44,NA,16.44,,15.74,94.58,94.58,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,02133641,,Repair heart septum defect,A,,28.84,9.81,NA,9.81,,7.28,45.93,45.93,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,02233645,,Revision of heart veins,A,,30.52,10.24,NA,10.24,,7.69,48.45,48.45,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,02333647,,Repair heart septum defects,A,,32.18,10.46,NA,10.46,,8.11,50.75,50.75,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00