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CPT code 33518: CABG grafts, two venous grafts2026 Medicare rate & RVUs

Add-on reporting for coronary bypass surgery using two venous grafts together with one or more arterial grafts.

CMS RVU26DEffective Oct 1, 2026109 payment localities32.7K Medicare services in 2024

Medicare pays $373.76 for 33518 nationally in a facility.

Medicare rate · 33518

CABG grafts, two venous grafts

Office or facility?

Work RVUs
7.73
Total RVUs
11.19
Global days
ZZZ

National rate · 2026

$373.76

Facility setting, before claim adjustments.

See every locality for 33518 →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 33518 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 33518 covers

This add-on represents the venous-graft portion of coronary artery bypass surgery when the operation also uses an arterial graft. A cardiac surgeon typically performs the bypass in a hospital operating room, using venous conduit such as saphenous vein to route blood around coronary artery blockages alongside an arterial conduit such as an internal mammary artery. The code is selected for two venous grafts; it does not represent two total grafts or the arterial graft count.

Report 33518 with the primary arterial CABG code that reflects the number of arterial grafts. The operative report should identify the arterial and venous conduits and document the number of each used. As an add-on, 33518 is billed only with a primary procedure and is paid within that procedure’s global period; it is not a stand-alone CABG report. The venous graft count determines this add-on level, while the arterial graft count determines the primary code.

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 33518 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

33518 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$339.60
AlaskaUnavailable$477.57
ArizonaUnavailable$362.96
ArkansasUnavailable$335.52
Atlanta, GAUnavailable$388.18
Austin, TXUnavailable$370.00
Bakersfield, CAUnavailable$358.69
Baltimore area, MDUnavailable$396.79
Beaumont, TXUnavailable$364.57
Brazoria, TXUnavailable$361.32

33518 rates by state

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

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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
33518 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 33518 rate is calculated

Each of 33518’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 · 33518

RVUs × geographic indexes × conversion factor

Office or facility?

Work7.73

7.73 RVUs× 1.000 GPCI

Practice expense1.55

1.55 RVUs× 1.000 GPCI

Malpractice1.91

1.91 RVUs× 1.000 GPCI

Adjusted RVUs

11.1900

Conversion factor

$33.4009

Medicare rate

$373.76

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

Payment rules and modifiers for 33518

The CMS indicators that decide how 33518 is paid alongside other services.

CMS payment indicators · 33518

CABG grafts, two venous grafts

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)0Not permitted.
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

33518 without 80 · national facility

$373.76

CABG grafts, two venous grafts

33518-80 · Assistant: 16%

$59.80

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

When to use modifier 80

33518 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 33518

    CABG grafts, two venous grafts7.73 wRVU

    Not priced

  • 33517

    Combined CABG, one venous graft3.52 wRVU

    Not priced

  • 33519

    CABG grafts, three venous grafts10.23 wRVU

    Not priced

  • 33511

    Coronary bypass, two venous grafts37.49 wRVU

    Not priced

  • 33533

    Arterial CABG, single arterial graft32.91 wRVU

    Not priced

How to choose

33517Combined CABGOne venous graft
Both codes represent venous grafting with arterial CABG. Choose 33517 for one venous graft and 33518 for two.
33519CABG graftsThree venous grafts
Both are mixed arterial-and-venous CABG add-ons. Choose 33519 when three venous grafts are documented rather than two.
33511Coronary bypassTwo venous grafts
33511 represents two venous grafts without the mixed arterial-and-venous coding structure. Use 33518 when arterial grafting is also performed and the primary arterial CABG code is reported.
33533Arterial CABGSingle arterial graft
33533 is the primary CABG code for one arterial graft. It does not capture the two venous grafts represented by add-on code 33518.

Codes related to 33518

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

Codes related to 33518
CodeHow it relatesNational office range
Same family
33517Combined CABG, one venous graftSame mixed arterial-and-venous CABG series, for one venous graft.No office rate
33519CABG grafts, three venous graftsSame mixed arterial-and-venous CABG series, for three venous grafts.No office rate
Used instead
33511Coronary bypass, two venous graftsRepresents two venous grafts when CABG uses venous grafting without the arterial-graft combination.No office rate
Primary code
33533Arterial CABG, single arterial graftPrimary CABG code for one arterial graft; report with 33518 when two venous grafts are also used.No office rate
33534Arterial CABG, two arterial graftsPrimary CABG code for two arterial grafts; report with 33518 when two venous grafts are also used.No office rate
Often billed with
33508Vein harvest, endoscopic techniqueEndoscopic vein harvesting may accompany CABG when vein conduit is procured endoscopically.No office rate

33518 billing questions

Does 33518 mean two total bypass grafts?

No. It represents two venous grafts used with arterial grafting. The primary arterial CABG code reflects the arterial graft count.

Which primary code is reported with 33518?

Report the arterial CABG code for the number of arterial grafts, such as 33533 for one arterial graft or 33534 for two.

How does 33518 differ from 33511?

33518 is for two venous grafts used with arterial grafting. 33511 represents two venous grafts without the arterial-graft combination represented by 33518.

What documentation supports the two-graft level?

The operative report should identify the graft types and document two venous grafts, along with the arterial grafting that supports the primary CABG code.

Can 33518 be reported by itself?

No. It is an add-on code reported with the primary arterial CABG procedure and is paid within that procedure’s global period.

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 33518PPRRVU2026_Oct_nonQPP.csv, line 3,990 (RVU26D)

Open CMS sourceHow we calculate rates

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