Billing code 33845: Coarctation repairMedicare rate & RVUs in Washington
Open repair of aortic coarctation by removing the narrowed segment and restoring aortic continuity with a graft.
CMS doesn’t publish an office rate for 33845 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 33845 covers
A cardiothoracic surgeon removes a narrowed segment of the aorta caused by coarctation and reconstructs the vessel with a graft. The operation treats congenital narrowing of the thoracic aorta when the surgeon uses graft reconstruction rather than joining the remaining aortic ends directly. It is performed in an operating room, generally as an open cardiac or vascular procedure.
Report this code when the operative record supports both excision of the coarctation and graft reconstruction; a direct end-to-end repair is a different technique. Documentation should identify the treated aortic segment, the excision, and the graft repair. This major operation has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. 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% reduction. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation. Team surgery is not permitted, and modifier 50 is inappropriate.
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 33845 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $1,260.26 |
| Seattle (King Cnty) | Unavailable | $1,358.03 |
How the 33845 rate is calculated
Each of 33845’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 · 33845
RVUs × geographic indexes × conversion factor
Work22.36
22.36 RVUs× 1.000 GPCI
Practice expense10.26
10.26 RVUs× 1.000 GPCI
Malpractice5.62
5.62 RVUs× 1.000 GPCI
Adjusted RVUs
38.2400
Conversion factor
$33.4009
Medicare rate
$1,277.25
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33845
33845 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33845
Coarctation 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 · 33845
Coarctation 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
33845 without 51 · national facility
$1,277.25
Coarctation repair
33845-51 · Second procedure: 50%
$638.63
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%).
33845 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 33840Coarctation repair
- Use 33845 when the excised aortic segment is reconstructed with a graft; use 33840 when the surgeon joins the aortic ends directly.
- 33851Coarctation repair
- This is a related coarctation repair involving the left subclavian artery. Select the code that matches the reconstruction documented in the operative report.
- 33852Aortic arch repair
- Code 33852 addresses repair of a hypoplastic aortic arch without bypass, rather than excision of a coarctation with graft reconstruction.
33845 billing questions
How does this differ from 33840?
Code 33845 describes excision followed by graft reconstruction. Code 33840 is for excision with direct anastomosis of the aortic ends.
What operative documentation supports 33845?
The operative report should establish that the coarctation was excised and that a graft was used to reconstruct the aorta. A graft repair without documented excision may not support this code.
Is the preoperative visit or routine postoperative care separately reported?
The day-before preoperative visit and related postoperative care during the 90-day global period are included in the global surgical payment.
Can modifier 50 be used?
No. CMS identifies bilateral adjustment as inappropriate for this code.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, and 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
Fee sheets
Put 33845 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →