Billing code 33781: Transposition repairMedicare rate & RVUs in Texas
Reports complex surgical repair of transposition of the great arteries involving reconstruction and relief of subpulmonary obstruction.
CMS doesn’t publish an office rate for 33781 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 33781 covers
This code describes surgical correction of transposition of the great arteries that includes reconstruction and repair of an obstruction below the pulmonary valve. The obstruction can restrict blood flow from the right ventricle toward the pulmonary arteries. A congenital cardiac surgeon typically performs the operation in a hospital operating room as part of complex open-heart care for a patient with congenital heart disease.
Select the code when the operative report supports both the transposition reconstruction and repair of the subpulmonary obstruction. Document the congenital anatomy, the reconstruction performed, and the specific obstruction addressed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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 payment reduction. Assistant-at-surgery services may be paid. Report this as a single cardiac repair, not as a bilateral procedure; co-surgeons and team surgery are 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 33781 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 | $2,109.40 |
| Beaumont | Unavailable | $2,068.02 |
| Brazoria | Unavailable | $2,055.84 |
| Dallas | Unavailable | $2,086.76 |
| Fort Worth | Unavailable | $2,087.74 |
| Galveston | Unavailable | $2,073.61 |
| Houston | Unavailable | $2,268.18 |
| Rest Of Texas | Unavailable | $2,072.98 |
How the 33781 rate is calculated
Each of 33781’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 · 33781
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 42.13Practice expense 10.89Malpractice 10.63
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 33781
33781 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33781
Transposition 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) | 0 | Not permitted. |
| 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 · 33781
Transposition 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
33781 without 51 · national facility
$2,125.97
Transposition repair
33781-51 · Second procedure: 50%
$1,062.99
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%).
33781 compared with similar codes
Compare codes
33781 vs 33777 vs 33780 vs 33782: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 33777TGA repair
- Use 33777 for the atrial-baffle approach with subpulmonary obstruction repair. This code represents reconstruction-based repair.
- 33780Transposition repair
- Use 33780 when ventricular septal defect closure accompanies the reconstruction. This code identifies repair of subpulmonary obstruction.
- 33782Nikaidoh repair
- 33782 identifies a Nikaidoh procedure, a distinct operative approach. Choose based on the operation documented, not the diagnosis alone.
33781 billing questions
How is this different from 33777?
33777 describes a transposition repair using an atrial baffle with relief of subpulmonary obstruction. This code is for a reconstruction-based repair.
Can an assistant surgeon be reported?
CMS permits payment for assistant-at-surgery services for this procedure when the assistant's role is supported by the record.
Can two surgeons report co-surgeon services?
No. CMS does not permit co-surgeon billing for this code, and team-surgery billing is also not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How does the multiple-procedure reduction work?
For procedures performed in the same session, CMS pays the highest-valued procedure in full and applies the standard 50% reduction to the others.
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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