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CPT code 33536: CABG, four or more arterial grafts2026 Medicare rate & RVUs

Reports coronary artery bypass surgery using four or more arterial grafts, such as internal thoracic or radial artery conduits, for coronary revascularization.

CMS RVU26DEffective Oct 1, 2026109 payment localities255 Medicare services in 2024

Medicare pays $2,460.64 for 33536 nationally in a facility.

Medicare rate · 33536

CABG, four or more arterial grafts

Office or facility?

Work RVUs
47.22
Total RVUs
73.67
Global days
090

National rate · 2026

$2,460.64

Facility setting, before claim adjustments.

See every locality for 33536 →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 33536 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 33536 covers

This code describes coronary artery bypass grafting with four or more arterial grafts. Cardiothoracic surgeons perform the operation, generally in a hospital operating room, to revascularize coronary arteries affected by obstructive disease. Arterial conduits may include an internal thoracic artery or a radial artery. The operative report should identify the conduits used and the number of arterial bypass grafts performed.

Select this code based on the arterial graft count, not the combined number of arterial and venous grafts. When venous grafts are also used, report the appropriate venous-graft add-on code with the arterial CABG code. The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment may be available; co-surgeon and team-surgery payment are not permitted for this 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 33536 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

33536 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$2,229.97
AlaskaUnavailable$3,106.66
ArizonaUnavailable$2,389.29
ArkansasUnavailable$2,202.22
Atlanta, GAUnavailable$2,551.50
Austin, TXUnavailable$2,448.11
Bakersfield, CAUnavailable$2,385.92
Baltimore area, MDUnavailable$2,614.19
Beaumont, TXUnavailable$2,388.53
Brazoria, TXUnavailable$2,383.21

33536 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
33536 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 33536 rate is calculated

Each of 33536’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 · 33536

RVUs × geographic indexes × conversion factor

Office or facility?

Work47.22

47.22 RVUs× 1.000 GPCI

Practice expense14.80

14.80 RVUs× 1.000 GPCI

Malpractice11.65

11.65 RVUs× 1.000 GPCI

Adjusted RVUs

73.6700

Conversion factor

$33.4009

Medicare rate

$2,460.64

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

Payment rules and modifiers for 33536

33536 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 33536

CABG, four or more arterial grafts

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
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.
Split (54/55/56)0.09/0.82/0.09Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 33536

CABG, four or more arterial grafts

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

33536 without 51 · national facility

$2,460.64

CABG, four or more arterial grafts

33536-51 · Second procedure: 50%

$1,230.32

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%).

When to use modifier 51

33536 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 33536

    CABG, four or more arterial grafts47.22 wRVU

    Not priced

  • 33535

    Arterial CABG, three bypasses43.63 wRVU

    Not priced

  • 33534

    Arterial CABG, two arterial grafts38.88 wRVU

    Not priced

  • 33513

    Coronary bypass, four venous grafts44.24 wRVU

    Not priced

  • 33521

    CABG grafting, four venous grafts12.28 wRVU

    Not priced

How to choose

33535Arterial CABGThree bypasses
Use 33535 when the operation includes three arterial grafts. This code is for four or more arterial grafts.
33534Arterial CABGTwo arterial grafts
Use 33534 for two arterial grafts; this code requires four or more.
33513Coronary bypassFour venous grafts
33513 describes CABG with four venous grafts. This code describes four or more arterial grafts, with venous grafts handled separately when present.
33521CABG graftingFour venous grafts
33521 is an add-on for four venous grafts used with arterial CABG; it does not replace the primary arterial CABG code.

Codes related to 33536

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

Codes related to 33536
CodeHow it relatesNational office range
Same family
33535Arterial CABG, three bypassesArterial CABG sibling for three arterial grafts.No office rate
33534Arterial CABG, two arterial graftsArterial CABG sibling for two arterial grafts.No office rate
Add-on codes
33517Combined CABG, one venous graftAdd-on for one venous graft when reported with arterial CABG.No office rate
33523CABG grafting, six or more venous graftsAdd-on for six or more venous grafts with arterial CABG.No office rate
Used instead
33513Coronary bypass, four venous graftsCABG with four venous grafts rather than four or more arterial grafts.No office rate

33536 billing questions

How many grafts qualify for this code?

Use it when the operative documentation supports four or more arterial bypass grafts. For fewer arterial grafts, select the corresponding lower-count arterial CABG code.

Do venous grafts count toward the four-graft threshold?

No. Select the arterial CABG code by the number of arterial grafts; report the appropriate venous-graft add-on code when venous grafts are also used.

What documentation supports reporting this code?

The operative report should identify the arterial conduits and document the number of arterial bypass grafts performed. It should also distinguish any venous grafts used during the operation.

How does the 90-day global period affect postoperative billing?

The day-before preoperative visit and related postoperative care for 90 days after surgery are included in this code's global period.

Can an assistant surgeon or co-surgeon be reported?

Assistant-at-surgery payment may be available. Co-surgeon and team-surgery payment are not permitted for this code.

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 33536PPRRVU2026_Oct_nonQPP.csv, line 4,001 (RVU26D)

Open CMS sourceHow we calculate rates

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