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CPT code 33340: Appendage closure, transcatheter implant2026 Medicare rate & RVUs

Reports catheter-based placement of an implant to close the left atrial appendage, commonly for stroke-risk reduction in patients with atrial fibrillation.

CMS RVU26DEffective Oct 1, 2026109 payment localities60.1K Medicare services in 2024

Medicare pays $618.58 for 33340 nationally in a facility.

Medicare rate · 33340

Appendage closure, transcatheter implant

Office or facility?

Work RVUs
9.99
Total RVUs
18.52
Global days
000

National rate · 2026

$618.58

Facility setting, before claim adjustments.

See every locality for 33340 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 33340 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 33340 covers

An interventional cardiologist or electrophysiologist advances a catheter through a transseptal route and places an endocardial implant to close the left atrial appendage. The procedure is generally performed in a hospital catheterization or electrophysiology lab with imaging guidance. It is used for selected patients with atrial fibrillation when a strategy to reduce embolic stroke risk is being pursued; the record should identify the indication, implant placement, and procedural findings.

Report 33340 for the transcatheter closure procedure, including its transseptal access and integral fluoroscopic and angiographic guidance. The code has a 0-day global period, so same-day preoperative and postoperative care is included. If other procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this anatomy. Assistant-at-surgery payment requires documented medical necessity; co-surgeons are permitted, and team-surgery payment requires supporting documentation.

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 33340 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

33340 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$558.72
AlaskaUnavailable$763.60
ArizonaUnavailable$600.88
ArkansasUnavailable$551.41
Atlanta, GAUnavailable$638.67
Austin, TXUnavailable$622.28
Bakersfield, CAUnavailable$614.05
Baltimore area, MDUnavailable$657.59
Beaumont, TXUnavailable$594.43
Brazoria, TXUnavailable$602.13

33340 rates by state

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

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Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
33340 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 33340 rate is calculated

Each of 33340’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 · 33340

RVUs × geographic indexes × conversion factor

Office or facility?

Work9.99

9.99 RVUs× 1.000 GPCI

Practice expense6.18

6.18 RVUs× 1.000 GPCI

Malpractice2.35

2.35 RVUs× 1.000 GPCI

Adjusted RVUs

18.5200

Conversion factor

$33.4009

Medicare rate

$618.58

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 33340

The CMS indicators that decide how 33340 is paid alongside other services.

CMS payment indicators · 33340

Appendage closure, transcatheter implant

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)2Permitted.
Team surgery (66)1Permitted with supporting documentation.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

33340 without 51 · national facility

$618.58

Appendage closure, transcatheter implant

33340-51 · Second procedure: 50%

$309.29

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%).

When to use modifier 51

33340 compared with similar codes

Compare codes · National

33340 vs 93656 vs 33361: Medicare rates

Office or facility?

  • 33340

    Appendage closure, transcatheter implant9.99 wRVU

    Not priced

  • 93656

    AF ablation, pulmonary vein isolation16.58 wRVU

    Not priced

  • 33361

    TAVR, percutaneous femoral approach21.91 wRVU

    Not priced

How to choose

93656AF ablationPulmonary vein isolation
93656 reports catheter ablation directed at atrial fibrillation. Use 33340 for placement of an implant to close the left atrial appendage; both services may be performed in one session.
33361TAVRPercutaneous femoral approach
33361 reports transcatheter replacement of the aortic valve. It treats a different cardiac structure and is not the code for left atrial appendage closure.

Codes related to 33340

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

Codes related to 33340
CodeHow it relatesNational office range
Often billed with
93312Transesophageal echo, complete serviceTransesophageal echocardiography may be performed to image the heart during appendage implant placement.$215.12–$317.47
93662Intracardiac ultrasound, EP procedure imagingIntracardiac echocardiography may provide imaging during catheter-based appendage closure.No office rate
93656AF ablation, pulmonary vein isolationAtrial fibrillation ablation may be performed during the same session in selected cases.No office rate

33340 billing questions

When should 33340 be reported instead of an atrial fibrillation ablation code?

Report 33340 for catheter-based implant closure of the left atrial appendage. Atrial fibrillation ablation treats the arrhythmia itself; appendage closure is intended to reduce embolic stroke risk.

Does 33340 include transseptal access and fluoroscopic guidance?

Yes. The closure service includes the transseptal catheter access and integral fluoroscopic and angiographic guidance used for implant placement.

Can an assistant surgeon be billed for this procedure?

Assistant-at-surgery payment is allowed only when the record supports medical necessity. Co-surgeons are permitted, while team-surgery payment requires supporting documentation.

How does the 0-day global period affect same-day care?

Same-day preoperative and postoperative care is included in the procedure. The code has no postoperative global days beyond the date of service.

How is 33340 paid when another procedure is performed in the same session?

The highest-valued procedure is paid in full, and the other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this procedure.

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
RVUs for 33340PPRRVU2026_Oct_nonQPP.csv, line 3,922 (RVU26D)

Open CMS sourceHow we calculate rates

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