No office rate
Both address aortic coarctation excision, but 33845 is for reconstruction with a graft; 33840 requires direct reconnection of the aortic ends.
On this page
CMS RVU26D · Effective 2026-10-01
33840 Coarctation repair Medicare reimbursement rates in Virginia
Reports surgical removal of a narrowed aortic segment followed by direct reconnection of the aortic ends to repair coarctation. Compare 33840 office and facility rates across CMS payment localities in Virginia.
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 33840 in Virginia?
Virginia 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
$1128.67–$1298.86
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.
Cardiothoracic surgery
About 33840: Coarctation excision with direct anastomosis
Reports surgical removal of a narrowed aortic segment followed by direct reconnection of the aortic ends to repair coarctation.
The surgeon removes the narrowed segment of the aorta and reconnects the remaining ends directly, creating an end-to-end anastomosis. This operation treats aortic coarctation, usually a congenital narrowing, and is typically performed by a congenital cardiac or cardiothoracic surgeon in a hospital operating room. Patients are often infants or children, though coarctation may be repaired later in life.
Choose this code when the operative report supports excision of the coarctation and direct anastomosis, rather than reconstruction with an interposition graft or patch. The 90-day global period includes 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 others are subject to the standard 50% reduction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation. Team surgery is not permitted, and modifier 50 is inappropriate for this anatomy.
CMS billing rules for 33840
- 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 RVU20.81 · 59%
- Practice expense (office) RVU9.45 · 27%
- Malpractice RVU5.23 · 15%
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.
33840 compared with similar codes
Office rates for Virginia, from the same CMS release.
No office rate
Choose 33851 for the specified left subclavian artery or prosthetic patch repair, rather than the direct end-to-end anastomosis reported with 33840.
No office rate
Code 33852 describes repair of a hypoplastic aortic arch without bypass. Code 33840 describes excision of a coarctation with direct anastomosis.
No office rate
Code 33853 describes repair of a hypoplastic aortic arch with bypass; 33840 is for coarctation excision and direct anastomosis.
Compare 33840 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
Dc + Md/Va Suburbs →
Office / nonfacility
Unavailable
Facility
$1298.86
Virginia →
Office / nonfacility
Unavailable
Facility
$1128.67
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33840 billing questions
How is this code distinguished from 33845?
Use 33840 when the surgeon reconnects the aortic ends directly after removing the narrowed segment. Code 33845 describes excision with graft reconstruction.
What operative documentation supports 33840?
The operative report should identify the coarctation, its excision, and direct anastomosis of the remaining aortic ends. Documentation of an interposition graft or patch points to a different repair method.
Can modifier 50 be appended?
No. The anatomy and descriptor make a bilateral adjustment inappropriate for this repair.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
4,08133822,,Repair pda div<18 years,A,,17.27,7.53,NA,7.53,,4.33,29.13,29.13,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,08233824,,Repair pda div 18 yrs&older,A,,19.72,9.20,NA,9.20,,4.95,33.87,33.87,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,0833382F,,Ajcc cln cncr stage 0 docd,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4,08433840,,Exc coa w/direct anastomosis,A,,20.81,9.45,NA,9.45,,5.23,35.49,35.49,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,08533845,,Excision coa w/graft,A,,22.36,10.26,NA,10.26,,5.62,38.24,38.24,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,0863384F,,Ajcc cln cncr stage 1 docd,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4,08733851,,Exc coa rpr l subcl art/prst,A,,21.43,9.58,NA,9.58,,5.39,36.40,36.40,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00