No office rate
Both describe Nikaidoh repairs. Choose 33783 when coronary ostia are reimplanted; choose 33782 when they are not.
On this page
CMS RVU26D · Effective 2026-10-01
33782 Nikaidoh repair Medicare reimbursement rates in Wyoming
Reports a Nikaidoh-type repair for complex congenital heart disease when the aortic root is translocated without coronary ostia reimplantation. Compare 33782 office and facility rates across CMS payment localities in Wyoming.
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 33782 in Wyoming?
Wyoming 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
$2846.24
1 of 1 localities have a supported rate.
Payment area: Wyoming**
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 heart surgery
About 33782: Nikaidoh repair without coronary reimplantation
Reports a Nikaidoh-type repair for complex congenital heart disease when the aortic root is translocated without coronary ostia reimplantation.
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.
CMS billing rules for 33782
- 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 RVU58.58 · 66%
- Practice expense (office) RVU15.69 · 18%
- Malpractice RVU14.79 · 17%
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.
33782 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
33781 describes a TGA repair with reconstruction addressing subpulmonary obstruction, not the Nikaidoh root-translocation approach.
No office rate
33780 describes TGA repair with aortic-pulmonary reconstruction and VSD closure; 33782 identifies a Nikaidoh repair without coronary ostia reimplantation.
Compare 33782 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
Wyoming** →
Office / nonfacility
Unavailable
Facility
$2846.24
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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 33782 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
4,070
- Code
- 33782
- Physician work
- 58.58
- Practice expense
- 15.69
- Malpractice
- 14.79
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 58.58 | × 1.000 | 58.5800 |
| Practice expense | 15.69 | × 1.000 | 15.6900 |
| Malpractice | 14.79 | × 0.740 | 10.9446 |
| Total RVUs | 85.2146 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$2846.24
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 58.58 | 1 |
| Practice expense | 15.69 | 1 |
| Malpractice | 14.79 | 0.74 |
(58.58 × 1 + 15.69 × 1 + 14.79 × 0.74) × $33.4009 = $2846.24
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.
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 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.
4,06733779,,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
4,07033782,,Nikaidoh proc,A,,58.58,15.69,NA,15.69,,14.79,89.06,89.06,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,07133783,,Nikaidoh proc w/ostia implt,A,,63.45,16.65,NA,16.65,,16.01,96.11,96.11,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,07233786,,Repair arterial trunk,A,,40.82,12.03,NA,12.03,,10.29,63.14,63.14,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,07333788,,Revision of pulmonary artery,A,,26.73,9.62,NA,9.62,,6.71,43.06,43.06,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,