CPT code 33509: Artery harvest, endoscopic, single segment2026 Medicare rate & RVUs in Texas
Reports endoscopic procurement of one upper-extremity artery segment as a conduit for coronary artery bypass surgery.
CMS doesn’t publish an office rate for 33509 in Texas.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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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 in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | $156.40 |
| Beaumont, TX | Unavailable | $154.08 |
| Brazoria, TX | Unavailable | $152.71 |
| Dallas, TX | Unavailable | $155.04 |
| Fort Worth, TX | Unavailable | $155.17 |
| Galveston, TX | Unavailable | $154.05 |
| Houston, TX | Unavailable | $168.88 |
| Rest of Texas | Unavailable | $154.24 |
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.
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.
33509 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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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