CPT code 33535: Arterial CABG, three bypasses2026 Medicare rate & RVUs in Virginia
Reported for coronary artery bypass surgery using three arterial grafts to create three bypasses, rather than a mixed arterial-and-venous graft pattern.
In Virginia, Medicare pays $2,172.36 for 33535 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 33535 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 33535 covers
This code represents coronary artery bypass surgery using arterial grafts for three coronary bypasses. A cardiac surgeon typically performs the operation in a hospital operating room. Common arterial conduits include the internal thoracic artery and radial artery. The operative report should identify the conduits used and the coronary targets bypassed so the arterial count and graft type are clear.
Select this level based on three arterial bypasses; use the mixed-conduit code family when the operation also uses venous grafts. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. CMS permits payment for an assistant at surgery, but does not permit co-surgeons or team surgery.
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 Virginia compares for 33535
Across 109 of 109 payment localities, the facility rate for 33535 runs from $2,018.10 in Wisconsin to $2,884.06 in Alaska. Virginia pays $2,172.36. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Virginia · this page$2,172.36
- Los Angeles, CA · California$2,311.13+$138.77
- Washington, DC area · District of Columbia$2,488.49+$316.13
- Miami, FL · Florida$2,852.38+$680.02
- Chicago, IL · Illinois$2,761.86+$589.50
- Manhattan, NY · New York$2,664.90+$492.54
- Alaska · Alaska$2,884.06+$711.70
Other areas in Virginia first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $2,071.44 |
| ArkansasArkansas | — | $2,045.66 |
| ArizonaArizona | — | $2,219.48 |
| Bakersfield, CACalifornia | — | $2,218.46 |
| Chico, CACalifornia | — | $2,189.41 |
| El Centro, CACalifornia | — | $2,191.20 |
| Fresno, CACalifornia | — | $2,189.41 |
| Hanford, CACalifornia | — | $2,189.41 |
| Madera, CACalifornia | — | $2,189.41 |
| Merced, CACalifornia | — | $2,189.41 |
| Modesto, CACalifornia | — | $2,189.41 |
| Napa, CACalifornia | — | $2,350.82 |
| Oxnard, CACalifornia | — | $2,277.03 |
| Redding, CACalifornia | — | $2,189.41 |
| Rest of CaliforniaCalifornia | — | $2,189.41 |
| Riverside, CACalifornia | — | $2,304.37 |
| Sacramento, CACalifornia | — | $2,248.60 |
| Salinas, CACalifornia | — | $2,239.44 |
| San Diego, CACalifornia | — | $2,257.53 |
| Marin County, CACalifornia | — | $2,423.17 |
| San Francisco, CACalifornia | — | $2,411.00 |
| San Benito County, CACalifornia | — | $2,487.65 |
| Santa Clara County, CACalifornia | — | $2,437.88 |
| San Luis Obispo, CACalifornia | — | $2,209.63 |
| Santa Cruz, CACalifornia | — | $2,251.20 |
| Santa Maria, CACalifornia | — | $2,238.36 |
| Santa Rosa, CACalifornia | — | $2,270.43 |
| Stockton, CACalifornia | — | $2,189.41 |
| Vallejo, CACalifornia | — | $2,333.27 |
| Visalia, CACalifornia | — | $2,189.41 |
| Yuba City, CACalifornia | — | $2,189.41 |
| ColoradoColorado | — | $2,254.79 |
| ConnecticutConnecticut | — | $2,426.17 |
| DelawareDelaware | — | $2,251.10 |
| Fort Lauderdale, FLFlorida | — | $2,581.05 |
| Rest of FloridaFlorida | — | $2,445.03 |
| Atlanta, GAGeorgia | — | $2,369.49 |
| Rest of GeorgiaGeorgia | — | $2,303.58 |
| Hawaii, Guam, HIHawaii | — | $2,199.31 |
| IowaIowa | — | $2,029.74 |
| IdahoIdaho | — | $2,059.30 |
| East St. Louis, ILIllinois | — | $2,611.07 |
| Rest of IllinoisIllinois | — | $2,446.30 |
| Suburban Chicago, ILIllinois | — | $2,584.94 |
| IndianaIndiana | — | $2,067.25 |
| KansasKansas | — | $2,062.88 |
| KentuckyKentucky | — | $2,202.99 |
| New Orleans, LALouisiana | — | $2,306.57 |
| Rest of LouisianaLouisiana | — | $2,216.50 |
| Metropolitan Boston, MAMassachusetts | — | $2,397.22 |
| Rest of MassachusettsMassachusetts | — | $2,261.18 |
| Baltimore area, MDMaryland | — | $2,428.13 |
| Rest of MarylandMaryland | — | $2,276.48 |
| Rest of MaineMaine | — | $2,112.66 |
| Southern Maine, MEMaine | — | $2,149.27 |
| Detroit, MIMichigan | — | $2,514.79 |
| Rest of MichiganMichigan | — | $2,290.90 |
| MinnesotaMinnesota | — | $2,047.19 |
| Metropolitan Kansas City, MOMissouri | — | $2,248.70 |
| Metropolitan St. Louis, MOMissouri | — | $2,263.77 |
| Rest of MissouriMissouri | — | $2,211.41 |
| MississippiMississippi | — | $2,126.80 |
| MontanaMontana | — | $2,284.91 |
| North CarolinaNorth Carolina | — | $2,124.86 |
| North DakotaNorth Dakota | — | $2,072.94 |
| NebraskaNebraska | — | $2,026.70 |
| New HampshireNew Hampshire | — | $2,260.15 |
| Northern New JerseyNew Jersey | — | $2,477.03 |
| Rest of New JerseyNew Jersey | — | $2,421.91 |
| New MexicoNew Mexico | — | $2,318.56 |
| NevadaNevada | — | $2,226.30 |
| NYC suburbs and Long Island, NYNew York | — | $2,774.63 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $2,471.07 |
| Queens, NYNew York | — | $2,622.74 |
| Rest of New YorkNew York | — | $2,155.77 |
| OhioOhio | — | $2,247.57 |
| OklahomaOklahoma | — | $2,155.46 |
| Portland, OROregon | — | $2,269.48 |
| Rest of OregonOregon | — | $2,177.40 |
| Metropolitan Philadelphia, PAPennsylvania | — | $2,400.24 |
| Rest of PennsylvaniaPennsylvania | — | $2,227.37 |
| Puerto RicoPuerto Rico | — | $2,285.43 |
| Rhode IslandRhode Island | — | $2,290.16 |
| South CarolinaSouth Carolina | — | $2,196.17 |
| South DakotaSouth Dakota | — | $2,047.87 |
| TennesseeTennessee | — | $2,077.05 |
| Austin, TXTexas | — | $2,275.00 |
| Beaumont, TXTexas | — | $2,217.88 |
| Brazoria, TXTexas | — | $2,214.28 |
| Dallas, TXTexas | — | $2,246.01 |
| Fort Worth, TXTexas | — | $2,245.97 |
| Galveston, TXTexas | — | $2,232.40 |
| Houston, TXTexas | — | $2,428.62 |
| Rest of TexasTexas | — | $2,226.91 |
| UtahUtah | — | $2,220.88 |
| Virgin Islands, VIUnited States Virgin Islands | — | $2,285.43 |
| VermontVermont | — | $2,104.04 |
| Rest of WashingtonWashington | — | $2,243.92 |
| King County, WAWashington | — | $2,399.72 |
| WisconsinWisconsin | — | $2,018.10 |
| West VirginiaWest Virginia | — | $2,378.34 |
| WyomingWyoming | — | $2,192.53 |
33535 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 33535 rate is calculated
Each of 33535’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 · 33535
RVUs × geographic indexes × conversion factor
Work43.63
43.63 RVUs× 1.000 GPCI
Practice expense14.08
14.08 RVUs× 1.000 GPCI
Malpractice10.72
10.72 RVUs× 1.000 GPCI
Adjusted RVUs
68.4300
Conversion factor
$33.4009
Medicare rate
$2,285.62
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Virginia inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
4,000
- Code
- 33535
- Physician work
- 43.63
- Practice expense
- 14.08
- Malpractice
- 10.72
GPCI2026.csv
106
- Locality
- Virginia
- Physician work
- 1.000
- Practice expense
- 0.983
- Malpractice
- 0.706
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 43.63 | × 1.000 | 43.6300 |
| Practice expense | 14.08 | × 0.983 | 13.8406 |
| Malpractice | 10.72 | × 0.706 | 7.5683 |
| Total RVUs | 65.0390 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Virginia$2172.36
Facility: (43.63 × 1 + 14.08 × 0.983 + 10.72 × 0.706) × $33.4009 = $2172.36
Payment rules and modifiers for 33535
33535 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33535
Arterial CABG, three bypasses
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| 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. |
| Split (54/55/56) | 0.09/0.82/0.09 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 33535
Arterial CABG, three bypasses
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
33535 without 51 · national facility
$2,285.62
Arterial CABG, three bypasses
33535-51 · Second procedure: 50%
$1,142.81
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
How 33535 has changed in Virginia
33535 · 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
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $2,172.36 | RVU26D |
| 2026-07-01 | Not available in this setting | $2,172.36 | RVU26C |
| 2026-04-01 | Not available in this setting | $2,172.36 | RVU26B |
| 2026-01-01 | Not available in this setting | $2,172.36 | RVU26A |
| 2025-10-01 | Not available in this setting | $2,245.23 | RVU25D |
| 2025-07-01 | Not available in this setting | $2,245.23 | RVU25C |
| 2025-04-01 | Not available in this setting | $2,245.23 | RVU25B |
| 2025-01-01 | Not available in this setting | $2,245.23 | RVU25A |
| 2024-10-01 | Not available in this setting | $2,299.80 | RVU24D |
| 2024-07-01 | Not available in this setting | $2,299.80 | RVU24C |
| 2024-04-01 | Not available in this setting | $2,299.80 | RVU24B |
| 2024-03-09 | Not available in this setting | $2,299.80 | RVU24AR |
| 2024-01-01 | Not available in this setting | $2,262.26 | RVU24A |
| 2023-10-01 | Not available in this setting | $2,361.49 | RVU23D |
| 2023-07-01 | Not available in this setting | $2,361.49 | RVU23C |
| 2023-04-01 | Not available in this setting | $2,361.49 | RVU23B |
| 2023-01-01 | Not available in this setting | $2,361.49 | RVU23A |
| 2022-10-01 | Not available in this setting | $2,444.12 | RVU22D |
| 2022-07-01 | Not available in this setting | $2,444.12 | RVU22C |
| 2022-04-01 | Not available in this setting | $2,444.12 | RVU22B |
| 2022-01-01 | Not available in this setting | $2,444.12 | RVU22A |
| 2021-10-01 | Not available in this setting | $2,456.04 | RVU21D |
| 2021-07-01 | Not available in this setting | $2,456.04 | RVU21C |
| 2021-04-01 | Not available in this setting | $2,456.04 | RVU21B |
| 2021-01-01 | Not available in this setting | $2,456.04 | RVU21A |
| 2020-10-01 | Not available in this setting | $2,522.28 | RVU20D |
| 2020-07-01 | Not available in this setting | $2,522.28 | RVU20C |
| 2020-04-01 | Not available in this setting | $2,522.28 | RVU20B |
| 2020-01-01 | Not available in this setting | $2,522.28 | RVU20A |
| 2019-10-01 | Not available in this setting | $2,516.26 | RVU19D |
| 2019-07-01 | Not available in this setting | $2,516.26 | RVU19C |
| 2019-04-01 | Not available in this setting | $2,516.26 | RVU19B |
| 2019-01-01 | Not available in this setting | $2,516.26 | RVU19A |
| 2018-10-01 | Not available in this setting | $2,509.83 | RVU18D |
| 2018-07-01 | Not available in this setting | $2,509.83 | RVU18C |
| 2018-04-01 | Not available in this setting | $2,509.83 | RVU18B |
| 2018-01-01 | Not available in this setting | $2,509.83 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $2,498.65 | RVU17D |
| 2017-07-01 | Not available in this setting | $2,498.65 | RVU17C |
| 2017-04-01 | Not available in this setting | $2,498.65 | RVU17B |
| 2017-01-01 | Not available in this setting | $2,498.65 | RVU17A |
| 2016-10-01 | Not available in this setting | $2,480.83 | RVU16D |
| 2016-07-01 | Not available in this setting | $2,480.83 | RVU16C |
| 2016-04-01 | Not available in this setting | $2,480.83 | RVU16B |
| 2016-01-01 | Not available in this setting | $2,480.83 | RVU16A |
| 2015-10-01 | Not available in this setting | $2,489.95 | RVU15D |
| 2015-07-01 | Not available in this setting | $2,489.95 | RVU15C |
| 2015-04-01 | Not available in this setting | $2,477.56 | RVU15B |
| 2015-01-01 | Not available in this setting | $2,477.56 | RVU15A |
| 2014-10-01 | Not available in this setting | $2,469.88 | RVU14D |
| 2014-07-01 | Not available in this setting | $2,469.88 | RVU14C |
| 2014-04-01 | Not available in this setting | $2,469.88 | RVU14B |
| 2014-01-01 | Not available in this setting | $2,469.88 | RVU14A |
| 2013-10-01 | Not available in this setting | $2,398.19 | RVU13D |
| 2013-07-01 | Not available in this setting | $2,398.19 | RVU13C |
| 2013-04-01 | Not available in this setting | $2,398.19 | RVU13B |
| 2013-01-01 | Not available in this setting | $2,398.19 | RVU13AR |
Where the Virginia rate applies
Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.
- Abbs Valley
- Abingdon
- Accomac
- Adwolf
- Afton
- Alberta
- Aldie
- Allison Gap
33535 billing questions
How is this code distinguished from the two- or four-bypass arterial codes?
Use this code when the operation includes three arterial bypasses. The adjacent arterial levels describe two bypasses and four or more bypasses.
Can this code be used when the surgeon also uses a vein graft?
Use the mixed arterial-and-venous CABG coding structure when both conduit types are used. This code describes the three-bypass arterial-only level.
What should the operative report document?
Document the arterial conduits used, the coronary targets bypassed, and the number of bypasses. These details support the arterial-only classification and three-bypass level.
Should modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for this code because its descriptor and anatomy are not bilateral.
How does the global period affect postoperative billing?
The 90-day global period includes the day-before preoperative visit and related postoperative care. CMS permits assistant-at-surgery payment, but not co-surgeon or team-surgery payment.
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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