CPT code 33782: Nikaidoh repair2026 Medicare rate & RVUs in Washington
Reports a Nikaidoh-type repair for complex congenital heart disease when the aortic root is translocated without coronary ostia reimplantation.
CMS doesn’t publish an office rate for 33782 in Washington.
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 33782 covers
Code 33782 represents a Nikaidoh-type anatomic repair for complex congenital disease, commonly transposition of the great arteries or double-outlet right ventricle with a ventricular septal defect and subpulmonary obstruction. The congenital cardiac surgeon translocates the aortic root to improve left-ventricle-to-aorta alignment and reconstructs the outflow pathways; the operation may include VSD closure. It is performed in an operating room, generally as open cardiac surgery.
Select 33782 when the operative report documents a Nikaidoh repair without coronary ostia reimplantation; use 33783 when ostia are reimplanted. The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and others at 50%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is not appropriate for this anatomy.
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 33782 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $2,909.83 |
| Seattle (King Cnty) | Unavailable | $3,101.08 |
How the 33782 rate is calculated
Each of 33782’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 · 33782
RVUs × geographic indexes × conversion factor
Work58.58
58.58 RVUs× 1.000 GPCI
Practice expense15.69
15.69 RVUs× 1.000 GPCI
Malpractice14.79
14.79 RVUs× 1.000 GPCI
Adjusted RVUs
89.0600
Conversion factor
$33.4009
Medicare rate
$2,974.68
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33782
33782 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33782
Nikaidoh 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 · 33782
Nikaidoh 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
33782 without 51 · national facility
$2,974.68
Nikaidoh repair
33782-51 · Second procedure: 50%
$1,487.34
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%).
33782 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 33783Nikaidoh repair
- Both describe Nikaidoh repairs. Choose 33783 when coronary ostia are reimplanted; choose 33782 when they are not.
- 33781Transposition repair
- 33781 describes a TGA repair with reconstruction addressing subpulmonary obstruction, not the Nikaidoh root-translocation approach.
- 33780Transposition repair
- 33780 describes TGA repair with aortic-pulmonary reconstruction and VSD closure; 33782 identifies a Nikaidoh repair without coronary ostia reimplantation.
33782 billing questions
When should 33783 be used instead of 33782?
Use 33783 when the Nikaidoh operation includes coronary ostia reimplantation. Code 33782 describes the repair without that step.
Can 33782 be reported with 33783 for the same operation?
These codes distinguish Nikaidoh repairs by whether coronary ostia are reimplanted. Select the code matching the documented operation rather than reporting both for that repair.
What documentation supports 33782?
The operative report should describe the aortic root translocation and the coronary ostia handling, along with the congenital anatomy and reconstruction performed.
How does the global period affect postoperative billing?
The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon or co-surgeon be paid?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
Should modifier 50 be appended?
No. Modifier 50 is inappropriate for this repair and its anatomy.
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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