No office rate
Use 33779 when the transposition reconstruction also includes removal of a pulmonary artery band, as documented in the operative report.
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CMS RVU26D · Effective 2026-10-01
33778 Arterial switch repair Medicare reimbursement rates in Wisconsin
Reports surgical correction of transposed great arteries by reconstructing the aorta and pulmonary artery, typically during an arterial switch operation. Compare 33778 office and facility rates across CMS payment localities in Wisconsin.
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 33778 in Wisconsin?
Wisconsin has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1928.83
1 of 1 localities have a supported rate.
Payment area: Wisconsin
One mapped payment locality.
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.
Congenital cardiac surgery
About 33778: Transposition repair with great-vessel reconstruction
Reports surgical correction of transposed great arteries by reconstructing the aorta and pulmonary artery, typically during an arterial switch operation.
This open-heart repair corrects transposition of the great arteries by restoring the aorta and pulmonary artery to the appropriate ventricular outflows. The surgeon divides and reconnects the great vessels and reconstructs their roots; coronary artery transfer is part of the usual arterial-switch approach. Congenital cardiac surgeons perform the operation in an operating room, often for infants with dextro-transposition of the great arteries.
Select this code when the documented operation includes the aortic and pulmonary artery reconstruction described by this repair, rather than an atrial-baffle repair or a separately specified reconstruction variant. The operative report should identify the anatomy, repair technique, great-vessel reconstruction, and any associated work such as VSD closure or relief of subpulmonary obstruction. The 90-day global period 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 other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 33778
- 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 RVU41.68 · 64%
- Practice expense (office) RVU13.39 · 20%
- Malpractice RVU10.52 · 16%
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.
33778 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
No office rate
Use 33780 for the reconstruction variant that includes VSD closure; 33778 describes the great-vessel reconstruction without that specified variant.
No office rate
Use 33781 when the reconstruction includes repair of subpulmonary obstruction, rather than the reconstruction represented by 33778 alone.
No office rate
Code 33774 represents an atrial-baffle repair. Code 33778 represents a great-vessel reconstruction approach.
Compare 33778 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.
1 of 1 payment localities
Wisconsin →
Office / nonfacility
Unavailable
Facility
$1928.83
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 33778 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
4,066
- Code
- 33778
- Physician work
- 41.68
- Practice expense
- 13.39
- Malpractice
- 10.52
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 41.68 | × 1.000 | 41.6800 |
| Practice expense | 13.39 | × 0.958 | 12.8276 |
| Malpractice | 10.52 | × 0.308 | 3.2402 |
| Total RVUs | 57.7478 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wisconsin$1928.83
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 41.68 | 1 |
| Practice expense | 13.39 | 0.958 |
| Malpractice | 10.52 | 0.308 |
(41.68 × 1 + 13.39 × 0.958 + 10.52 × 0.308) × $33.4009 = $1928.83
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
33778 billing questions
How is this code distinguished from an atrial-baffle repair?
This code describes great-vessel reconstruction in an arterial-switch-type repair. Code 33774 describes an atrial-baffle approach, which redirects blood flow within the atria rather than switching the great arteries.
Which code applies when the repair also closes a VSD?
Compare the operative details with 33780, the reconstruction variant identifying VSD closure. The report should establish the actual repair and associated work rather than relying on the diagnosis alone.
Is modifier 50 appropriate for this repair?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this operation.
How does the multiple-procedure reduction affect same-session surgery?
When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction.
What supports assistant or co-surgeon reporting?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What postoperative care is included in the global period?
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.
4,06333775,,Rpr tga atr bfl rmvl plm bnd,A,,32.17,12.02,NA,12.02,,8.11,52.30,52.30,0,090,0.09,0.84,0.07,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,06433776,,Rpr tga atr bfl clsr vsd,A,,33.88,12.95,NA,12.95,,8.55,55.38,55.38,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,06533777,,Rpr tga bfl rpr sbpulm obstr,A,,33.32,11.21,NA,11.21,,8.39,52.92,52.92,0,090,0.09,0.84,0.07,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,06633778,,Rpr tga aortic pulm art rcns,A,,41.68,13.39,NA,13.39,,10.52,65.59,65.59,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,06733779,,Rpr tga rcnstj rmvl plm bnd,A,,42.15,11.37,NA,11.37,,10.64,64.16,64.16,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,06833780,,Rpr tga rcnstj clsr vsd,A,,42.80,11.88,NA,11.88,,10.80,65.48,65.48,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,06933781,,Rpr tga rcnstj rpr sbpl obst,A,,42.13,10.89,NA,10.89,,10.63,63.65,63.65,0,090,0.09,0.84,0.07,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,