Billing code 33335: Aortic graftMedicare rate & RVUs in Texas
Reports placement of an aortic graft during open surgery using cardiopulmonary bypass to support circulation while the aorta is treated.
CMS doesn’t publish an office rate for 33335 in Texas.
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 33335 covers
This code captures placement of an aortic graft during an operation that uses cardiopulmonary bypass (CPB). A cardiac surgeon performs the reconstruction in an operating room, commonly when an aortic segment requires graft replacement or reconstruction. CPB supports circulation while the aorta is treated. The operative report should identify the aortic work and document use of bypass.
Report the code when the documented service is aortic graft placement with CPB, rather than direct vessel repair or graft placement without bypass. Documentation should establish the aortic segment treated, graft reconstruction, and CPB. The code has a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. For same-session multiple procedures, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. 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.
Where 33335 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $1,764.11 |
| Beaumont | Unavailable | $1,714.12 |
| Brazoria | Unavailable | $1,715.88 |
| Dallas | Unavailable | $1,739.64 |
| Fort Worth | Unavailable | $1,739.08 |
| Galveston | Unavailable | $1,729.39 |
| Houston | Unavailable | $1,874.54 |
| Rest Of Texas | Unavailable | $1,722.83 |
How the 33335 rate is calculated
Each of 33335’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 · 33335
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 33.06Practice expense 11.97Malpractice 7.93
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 33335
33335 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33335
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 · 33335
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
33335 without 51 · national facility
$1,768.91
Aortic graft
33335-51 · Second procedure: 50%
$884.46
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%).
33335 compared with similar codes
Compare codes
33335 vs 33330 vs 33320 vs 33321: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 33330Vessel graft
- Choose 33335 when the aortic graft operation uses cardiopulmonary bypass. Code 33330 describes the related graft procedure without bypass.
- 33320Major vessel repair
- Code 33320 is for direct repair of an intrathoracic blood vessel. Use 33335 for aortic graft placement with cardiopulmonary bypass.
- 33321Vessel repair
- Code 33321 concerns intrathoracic vessel repair using a graft; 33335 is specific to aortic graft placement with cardiopulmonary bypass.
33335 billing questions
How does this code differ from 33330?
Both concern aortic graft placement, but 33335 is for an operation using cardiopulmonary bypass. Code 33330 is the related option when bypass is not used.
What documentation supports reporting this code?
The operative report should describe the aortic segment treated, graft placement or reconstruction, and use of cardiopulmonary bypass.
Are related postoperative visits separately included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, while team surgery is not permitted.
Can modifier 50 be used for bilateral work?
No. The anatomy and descriptor make a bilateral adjustment inappropriate for this code.
How are additional procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%.
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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