CPT code 33523: CABG grafting, six or more venous grafts2026 Medicare rate & RVUs in Missouri
This add-on represents six or more venous grafts during coronary bypass that also uses arterial grafting, reported with the arterial CABG primary code.
CMS doesn’t publish an office rate for 33523 in Missouri.
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 33523 covers
During coronary artery bypass surgery, the surgeon uses venous conduits alongside arterial conduits to route blood around obstructed coronary arteries. This code represents the venous-graft portion when six or more venous grafts are used. It applies to CABG performed by a cardiac surgeon in an operating room. The primary arterial CABG code identifies the number of arterial grafts, while 33523 captures the venous-graft count.
Select the code from the operative report’s documented conduit and graft counts, rather than simply the number of coronary targets or distal connections. Report 33523 only with the appropriate primary arterial CABG code, 33533–33536, selected according to the arterial-graft count. The operative note should identify the conduits and support six or more venous grafts. CMS classifies 33523 as an add-on code: it is billed only with a primary procedure, and its payment falls within that 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 33523 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $747.09 |
| Metropolitan St. Louis, MO | Unavailable | $751.62 |
| Rest of Missouri | Unavailable | $738.43 |
How the 33523 rate is calculated
Each of 33523’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 · 33523
RVUs × geographic indexes × conversion factor
Work15.68
15.68 RVUs× 1.000 GPCI
Practice expense3.22
3.22 RVUs× 1.000 GPCI
Malpractice3.75
3.75 RVUs× 1.000 GPCI
Adjusted RVUs
22.6500
Conversion factor
$33.4009
Medicare rate
$756.53
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33523
The CMS indicators that decide how 33523 is paid alongside other services.
CMS payment indicators · 33523
CABG grafting, six or more venous grafts
| 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) | 0 | Not permitted. |
| 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
33523 without 80 · national facility
$756.53
CABG grafting, six or more venous grafts
33523-80 · Assistant: 16%
$121.04
A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.
33523 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 33522Coronary bypassFive venous grafts
- Use 33522 when the CABG includes arterial grafting and five venous grafts. 33523 represents six or more venous grafts.
- 33516Coronary bypassSix or more vein grafts
- 33516 represents six or more venous grafts for CABG without arterial grafting; 33523 is for the arterial-and-venous combination.
- 33536CABGFour or more arterial grafts
- 33536 represents the arterial-graft portion when four or more arterial grafts are used. 33523 represents six or more venous grafts and is reported as an add-on.
33523 billing questions
Which primary CABG code is reported with 33523?
Report it with the appropriate arterial CABG code from 33533–33536. The primary code reflects the arterial-graft count.
Does six or more refer to the arterial or venous grafts?
It refers to the venous grafts. The arterial-graft count is represented by the primary CABG code.
Can 33523 be reported by itself?
No. It is an add-on code billed only with a primary procedure, and CMS payment is within that procedure’s global period.
How does 33523 differ from 33516?
33523 represents six or more venous grafts in CABG that also uses arterial grafting. 33516 is for six or more venous grafts without arterial grafting.
What documentation supports 33523?
The operative report should identify the arterial and venous conduits and document six or more venous grafts.
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
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