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

In Puerto Rico, Medicare pays $157.82 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.

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 Puerto Rico 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. Puerto Rico pays $157.82. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

33509 rates by state

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

See 33509 in every payment locality

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.

Payment rules and modifiers for 33509

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

What modifiers do to the payment

When to use modifier 80

Codes related to 33509

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

How 33509 has changed in Puerto Rico

Price 33509 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

• Aceitunas
• Adjuntas
• Aguada
• Aguadilla
• Aguas Buenas
• Aguas Claras
• Aguilita
• Aibonito

Browse all communities in Puerto Rico

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