CPT code 33509: Artery harvest, endoscopic, single segment2026 Medicare rate & RVUs in Nevada
Reports endoscopic procurement of one upper-extremity artery segment as a conduit for coronary artery bypass surgery.
In Nevada, Medicare pays $153.49 for 33509 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 33509 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
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.
How Nevada compares for 33509
Across 109 of 109 payment localities, the facility rate for 33509 runs from $138.34 in Wisconsin to $201.72 in Alaska. Nevada pays $153.49. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Nevada · this page$153.49
- Los Angeles, CA · California$157.39+$3.90
- Washington, DC area · District of Columbia$170.85+$17.36
- Miami, FL · Florida$200.26+$46.77
- Chicago, IL · Illinois$193.89+$40.40
- Manhattan, NY · New York$184.38+$30.89
- Alaska · Alaska$201.72+$48.23
Other areas in Nevada first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $143.49 |
| ArkansasArkansas | — | $141.76 |
| ArizonaArizona | — | $153.41 |
| Bakersfield, CACalifornia | — | $151.59 |
| Chico, CACalifornia | — | $149.40 |
| El Centro, CACalifornia | — | $149.54 |
| Fresno, CACalifornia | — | $149.40 |
| Hanford, CACalifornia | — | $149.40 |
| Madera, CACalifornia | — | $149.40 |
| Merced, CACalifornia | — | $149.40 |
| Modesto, CACalifornia | — | $149.40 |
| Napa, CACalifornia | — | $158.55 |
| Oxnard, CACalifornia | — | $154.85 |
| Redding, CACalifornia | — | $149.40 |
| Rest of CaliforniaCalifornia | — | $149.40 |
| Riverside, CACalifornia | — | $158.09 |
| Sacramento, CACalifornia | — | $152.95 |
| Salinas, CACalifornia | — | $152.31 |
| San Diego, CACalifornia | — | $153.18 |
| Marin County, CACalifornia | — | $162.73 |
| San Francisco, CACalifornia | — | $161.81 |
| San Benito County, CACalifornia | — | $167.15 |
| Santa Clara County, CACalifornia | — | $163.39 |
| San Luis Obispo, CACalifornia | — | $150.35 |
| Santa Cruz, CACalifornia | — | $152.46 |
| Santa Maria, CACalifornia | — | $152.14 |
| Santa Rosa, CACalifornia | — | $153.73 |
| Stockton, CACalifornia | — | $149.40 |
| Vallejo, CACalifornia | — | $157.22 |
| Visalia, CACalifornia | — | $149.40 |
| Yuba City, CACalifornia | — | $149.40 |
| ColoradoColorado | — | $154.78 |
| ConnecticutConnecticut | — | $167.54 |
| DelawareDelaware | — | $155.53 |
| Fort Lauderdale, FLFlorida | — | $180.13 |
| Rest of FloridaFlorida | — | $170.62 |
| Atlanta, GAGeorgia | — | $164.10 |
| Rest of GeorgiaGeorgia | — | $160.80 |
| Hawaii, Guam, HIHawaii | — | $149.62 |
| IowaIowa | — | $139.80 |
| IdahoIdaho | — | $141.96 |
| East St. Louis, ILIllinois | — | $183.66 |
| Rest of IllinoisIllinois | — | $171.30 |
| Suburban Chicago, ILIllinois | — | $180.23 |
| IndianaIndiana | — | $142.47 |
| KansasKansas | — | $142.45 |
| KentuckyKentucky | — | $153.24 |
| New Orleans, LALouisiana | — | $160.37 |
| Rest of LouisianaLouisiana | — | $154.31 |
| Metropolitan Boston, MAMassachusetts | — | $163.75 |
| Rest of MassachusettsMassachusetts | — | $155.40 |
| Baltimore area, MDMaryland | — | $167.75 |
| Rest of MarylandMaryland | — | $157.12 |
| Rest of MaineMaine | — | $146.00 |
| Southern Maine, MEMaine | — | $147.80 |
| Detroit, MIMichigan | — | $175.77 |
| Rest of MichiganMichigan | — | $159.56 |
| MinnesotaMinnesota | — | $139.58 |
| Metropolitan Kansas City, MOMissouri | — | $156.02 |
| Metropolitan St. Louis, MOMissouri | — | $156.98 |
| Rest of MissouriMissouri | — | $154.24 |
| MississippiMississippi | — | $147.86 |
| MontanaMontana | — | $157.93 |
| North CarolinaNorth Carolina | — | $146.74 |
| North DakotaNorth Dakota | — | $141.92 |
| NebraskaNebraska | — | $139.46 |
| New HampshireNew Hampshire | — | $155.51 |
| Northern New JerseyNew Jersey | — | $170.21 |
| Rest of New JerseyNew Jersey | — | $166.99 |
| New MexicoNew Mexico | — | $161.59 |
| NYC suburbs and Long Island, NYNew York | — | $192.31 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $170.66 |
| Queens, NYNew York | — | $180.93 |
| Rest of New YorkNew York | — | $148.85 |
| OhioOhio | — | $156.28 |
| OklahomaOklahoma | — | $149.59 |
| Portland, OROregon | — | $155.25 |
| Rest of OregonOregon | — | $149.86 |
| Metropolitan Philadelphia, PAPennsylvania | — | $166.07 |
| Rest of PennsylvaniaPennsylvania | — | $154.69 |
| Puerto RicoPuerto Rico | — | $157.82 |
| Rhode IslandRhode Island | — | $157.86 |
| South CarolinaSouth Carolina | — | $152.25 |
| South DakotaSouth Dakota | — | $140.02 |
| TennesseeTennessee | — | $143.45 |
| Austin, TXTexas | — | $156.40 |
| Beaumont, TXTexas | — | $154.08 |
| Brazoria, TXTexas | — | $152.71 |
| Dallas, TXTexas | — | $155.04 |
| Fort Worth, TXTexas | — | $155.17 |
| Galveston, TXTexas | — | $154.05 |
| Houston, TXTexas | — | $168.88 |
| Rest of TexasTexas | — | $154.24 |
| UtahUtah | — | $153.90 |
| VirginiaVirginia | — | $149.66 |
| Virgin Islands, VIUnited States Virgin Islands | — | $157.82 |
| VermontVermont | — | $144.40 |
| Rest of WashingtonWashington | — | $154.10 |
| King County, WAWashington | — | $163.48 |
| WisconsinWisconsin | — | $138.34 |
| West VirginiaWest Virginia | — | $166.76 |
| WyomingWyoming | — | $150.95 |
33509 rates by state
Office rate range in each state. Select a state to see its payment localities.
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
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
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.
The exact Nevada inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
3,981
- Code
- 33509
- Physician work
- 3.26
- Practice expense
- 0.66
- Malpractice
- 0.81
GPCI2026.csv
73
- Locality
- Nevada
- Physician work
- 1.000
- Practice expense
- 1.001
- Malpractice
- 0.833
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.26 | × 1.000 | 3.2600 |
| Practice expense | 0.66 | × 1.001 | 0.6607 |
| Malpractice | 0.81 | × 0.833 | 0.6747 |
| Total RVUs | 4.5954 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Nevada$153.49
Facility: (3.26 × 1 + 0.66 × 1.001 + 0.81 × 0.833) × $33.4009 = $153.49
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician 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.
How 33509 has changed in Nevada
33509 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2022
RVU22A
No ratechanged toNo rate
Held through RVU22B, RVU22C, RVU22D, RVU23A, RVU23B, RVU23C, RVU23D, RVU24A, RVU24AR, RVU24B, RVU24C, RVU24D, RVU25A, RVU25B, RVU25C, RVU25D, RVU26A, RVU26B, RVU26C, RVU26D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D, RVU19A, RVU19B, RVU19C, RVU19D, RVU20A, RVU20B, RVU20C, RVU20D, RVU21A, RVU21B, RVU21C, RVU21D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $153.49 | RVU26D |
| 2026-07-01 | Not available in this setting | $153.49 | RVU26C |
| 2026-04-01 | Not available in this setting | $153.49 | RVU26B |
| 2026-01-01 | Not available in this setting | $153.49 | RVU26A |
| 2025-10-01 | Not available in this setting | $160.61 | RVU25D |
| 2025-07-01 | Not available in this setting | $160.61 | RVU25C |
| 2025-04-01 | Not available in this setting | $160.61 | RVU25B |
| 2025-01-01 | Not available in this setting | $160.61 | RVU25A |
| 2024-10-01 | Not available in this setting | $164.00 | RVU24D |
| 2024-07-01 | Not available in this setting | $164.00 | RVU24C |
| 2024-04-01 | Not available in this setting | $164.00 | RVU24B |
| 2024-03-09 | Not available in this setting | $164.00 | RVU24AR |
| 2024-01-01 | Not available in this setting | $161.32 | RVU24A |
| 2023-10-01 | Not available in this setting | $174.06 | RVU23D |
| 2023-07-01 | Not available in this setting | $174.06 | RVU23C |
| 2023-04-01 | Not available in this setting | $174.06 | RVU23B |
| 2023-01-01 | Not available in this setting | $174.06 | RVU23A |
| 2022-10-01 | Not available in this setting | $185.51 | RVU22D |
| 2022-07-01 | Not available in this setting | $185.51 | RVU22C |
| 2022-04-01 | Not available in this setting | $185.51 | RVU22B |
| 2022-01-01 | Not available in this setting | $185.51 | RVU22A |
| 2021-10-01 | Not in this release | Not in this release | RVU21D |
| 2021-07-01 | Not in this release | Not in this release | RVU21C |
| 2021-04-01 | Not in this release | Not in this release | RVU21B |
| 2021-01-01 | Not in this release | Not in this release | RVU21A |
| 2020-10-01 | Not in this release | Not in this release | RVU20D |
| 2020-07-01 | Not in this release | Not in this release | RVU20C |
| 2020-04-01 | Not in this release | Not in this release | RVU20B |
| 2020-01-01 | Not in this release | Not in this release | RVU20A |
| 2019-10-01 | Not in this release | Not in this release | RVU19D |
| 2019-07-01 | Not in this release | Not in this release | RVU19C |
| 2019-04-01 | Not in this release | Not in this release | RVU19B |
| 2019-01-01 | Not in this release | Not in this release | RVU19A |
| 2018-10-01 | Not in this release | Not in this release | RVU18D |
| 2018-07-01 | Not in this release | Not in this release | RVU18C |
| 2018-04-01 | Not in this release | Not in this release | RVU18B |
| 2018-01-01 | Not in this release | Not in this release | RVU18AR1 |
| 2017-10-01 | Not in this release | Not in this release | RVU17D |
| 2017-07-01 | Not in this release | Not in this release | RVU17C |
| 2017-04-01 | Not in this release | Not in this release | RVU17B |
| 2017-01-01 | Not in this release | Not in this release | RVU17A |
| 2016-10-01 | Not in this release | Not in this release | RVU16D |
| 2016-07-01 | Not in this release | Not in this release | RVU16C |
| 2016-04-01 | Not in this release | Not in this release | RVU16B |
| 2016-01-01 | Not in this release | Not in this release | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Nevada rate applies
Nevada is a Medicare payment area, not a city. Our Census mapping connects it to 138 cities and communities in Nevada. Some span more than one payment area; confirm with the service ZIP.
- Alamo
- Amargosa Valley
- Austin
- Baker
- Battle Mountain
- Beatty
- Beaverdam
- Bennett Springs
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
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