Billing code 33611: Congenital heart repairMedicare rate & RVUs in Texas
Reports surgical reconstruction of double-outlet right ventricle by creating an intracardiac pathway that directs left ventricular blood toward the aorta.
CMS doesn’t publish an office rate for 33611 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 33611 covers
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.
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 33611 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 | $1,806.61 |
| Beaumont | Unavailable | $1,762.67 |
| Brazoria | Unavailable | $1,758.09 |
| Dallas | Unavailable | $1,783.85 |
| Fort Worth | Unavailable | $1,783.98 |
| Galveston | Unavailable | $1,772.83 |
| Houston | Unavailable | $1,932.81 |
| Rest Of Texas | Unavailable | $1,769.35 |
How the 33611 rate is calculated
Each of 33611’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 · 33611
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 34.68Practice expense 10.96Malpractice 8.74
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 33611
33611 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33611
Congenital heart repair
| 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 · 33611
Congenital heart repair
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
33611 without 51 · national facility
$1,816.34
Congenital heart repair
33611-51 · Second procedure: 50%
$908.17
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%).
33611 compared with similar codes
Compare codes
33611 vs 33612 vs 33608 vs 33622: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 33612Cardiac repair
- Both address double-outlet right ventricle. Choose 33612 when the operation also repairs pulmonary stenosis, with or without conduit placement.
- 33608Conduit repair
- 33611 describes intracardiac tunnel reconstruction for double-outlet right ventricle; 33608 is for a congenital anomaly repair involving a conduit.
- 33622Congenital heart surgery
- Use 33622 for a complex redo congenital cardiac anomaly repair, rather than the specific double-outlet right ventricle tunnel repair described by 33611.
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 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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