CPT code 33018: Pericardial drainage, age 0–5 or congenital anomaly2026 Medicare rate & RVUs

Medicare pays $251.51 for 33018 nationally in a facility.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 33018 covers

A physician accesses the pericardial space through the skin and drains fluid, using imaging guidance when performed to guide access. Typical situations include a clinically significant pericardial effusion or tamponade in an infant or young child, or drainage in a patient of any age with a congenital cardiac anomaly. Cardiologists and other physicians experienced in pericardial procedures perform this service in hospital or procedural settings.

Report 33018 for percutaneous pericardial drainage when the patient is age 0–5 or has a congenital cardiac anomaly; that distinction separates it from 33017. Imaging guidance is included when performed. Documentation should support the patient’s age or congenital cardiac history, the clinical indication, percutaneous access, and drainage performed. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. In a session with multiple procedures, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate for this single pericardial target. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.

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 33018 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

33018 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 33018 rate is calculated

Each of 33018’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.

Payment rules and modifiers for 33018

The CMS indicators that decide how 33018 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

33018 compared with similar codes

How to choose

33017Pericardial drainageAge 6+, no congenital anomaly

Both describe percutaneous pericardial drainage. Choose 33018 for age 0–5 or any age with a congenital cardiac anomaly; 33017 is for age 6 or older without one.

33019Pericardial drainageCT-guided catheter placement

33019 specifies drainage with insertion of an indwelling catheter. For 33018, the patient must meet the age or congenital-anomaly criterion and the service must match that code.

33016PericardiocentesisImaging included

33016 is the pericardiocentesis code. Use 33018 for the specified patient group when the service is percutaneous pericardial drainage.

33025Pericardial windowOpen surgical drainage

33025 is a surgical pericardial-window procedure; 33018 is percutaneous drainage.

Codes related to 33018

Related codes aren’t interchangeable: bill the code that matches the service performed.

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

Open CMS sourceHow we calculate rates