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CPT code 33509: Artery harvest, endoscopic, single segment2026 Medicare rate & RVUs

Reports endoscopic procurement of one upper-extremity artery segment as a conduit for coronary artery bypass surgery.

CMS RVU26DEffective Oct 1, 2026109 payment localities2.6K Medicare services in 2024

Medicare pays $157.99 for 33509 nationally in a facility.

Medicare rate · 33509

Artery harvest, endoscopic, single segment

Office or facility?

Work RVUs
3.26
Total RVUs
4.73
Global days
ZZZ

National rate · 2026

$157.99

Facility setting, before claim adjustments.

See every locality for 33509 →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 33509 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 33509 covers

This add-on represents endoscopic harvest of one upper-extremity artery segment, typically the radial artery, for use as a coronary bypass conduit. The surgeon or surgical team performs the harvest during the operative episode for CABG, usually in a hospital operating room. The endoscopic approach uses small access incisions to free and retrieve the artery segment for grafting.

Report 33509 with an eligible primary CABG procedure; it is not submitted as a standalone service. The operative report should identify the upper-extremity artery, the segment harvested, the endoscopic technique, and its intended use for bypass grafting. The primary CABG code reflects the bypass procedure and graft configuration, while 33509 captures this separate harvest work. CMS treats this as an add-on code paid within the primary procedure’s global period.

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 33509 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

33509 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$143.49
AlaskaUnavailable$201.72
ArizonaUnavailable$153.41
ArkansasUnavailable$141.76
Atlanta, GAUnavailable$164.10
Austin, TXUnavailable$156.40
Bakersfield, CAUnavailable$151.59
Baltimore area, MDUnavailable$167.75
Beaumont, TXUnavailable$154.08
Brazoria, TXUnavailable$152.71

33509 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
33509 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 33509 rate is calculated

Each of 33509’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 · 33509

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.26

3.26 RVUs× 1.000 GPCI

Practice expense0.66

0.66 RVUs× 1.000 GPCI

Malpractice0.81

0.81 RVUs× 1.000 GPCI

Adjusted RVUs

4.7300

Conversion factor

$33.4009

Medicare rate

$157.99

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

Payment rules and modifiers for 33509

The CMS indicators that decide how 33509 is paid alongside other services.

CMS payment indicators · 33509

Artery harvest, endoscopic, single segment

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 80 · payment effect

With and without the modifier

33509 without 80 · national facility

$157.99

Artery harvest, endoscopic, single segment

33509-80 · Assistant: 16%

$25.28

A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.

When to use modifier 80

33509 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 33509

    Artery harvest, endoscopic, single segment3.26 wRVU

    Not priced

  • 33508

    Vein harvest, endoscopic technique0.3 wRVU

    Not priced

  • 33510

    Coronary bypass, single vein graft34.11 wRVU

    Not priced

  • 33533

    Arterial CABG, single arterial graft32.91 wRVU

    Not priced

How to choose

33508Vein harvestEndoscopic technique
Use 33509 for endoscopic upper-extremity artery harvest and 33508 for endoscopic vein harvest. The conduit harvested determines which harvest code describes the service.
33510Coronary bypassSingle vein graft
33510 reports a primary CABG procedure using a single venous graft configuration; 33509 reports endoscopic harvest of one upper-extremity artery segment.
33533Arterial CABGSingle arterial graft
33533 reports a primary CABG procedure using a single arterial graft. 33509 captures endoscopic procurement of an upper-extremity artery segment as an add-on.

Codes related to 33509

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

Codes related to 33509
CodeHow it relatesNational office range
Primary code
33510Coronary bypass, single vein graftPrimary CABG code for a single venous graft configuration.No office rate
33517Combined CABG, one venous graftPrimary CABG code for a single arterial and venous graft combination.No office rate
33533Arterial CABG, single arterial graftPrimary CABG code for a single arterial graft.No office rate
Often billed with
33508Vein harvest, endoscopic techniqueEndoscopic vein harvest may accompany CABG when a vein conduit is also harvested.No office rate

33509 billing questions

Can 33509 be reported by itself?

No. It is an add-on code and must be reported with a primary CABG procedure.

How is 33509 different from 33508?

33509 is for endoscopic harvest of an upper-extremity artery segment; 33508 describes endoscopic vein harvest.

Does 33509 replace the CABG procedure code?

No. Report the appropriate primary CABG code for the bypass procedure, and report 33509 for the endoscopic artery harvest when supported.

What documentation supports reporting 33509?

The operative report should identify the upper-extremity artery harvested, the single segment, the endoscopic method, and its use as a CABG conduit.

How many segments does this code represent?

The code describes one segment. The operative documentation should support the segment harvested and its role in the bypass 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 33509PPRRVU2026_Oct_nonQPP.csv, line 3,981 (RVU26D)

Open CMS sourceHow we calculate rates

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