CPT code 33750: Systemic-to-pulmonary shunt, subclavian artery connection2026 Medicare rate & RVUs in Texas

Reports a palliative congenital heart operation connecting the subclavian artery with a pulmonary artery to increase pulmonary blood flow in selected patients.

CMS RVU26DEffective Oct 1, 20268 payment localities

CMS doesn’t publish an office rate for 33750 in Texas.

—Office (non-facility)
$1,154.58–$1,265.63Hospital or facility

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 9 sections
  1. Rate in Texas
  2. What 33750 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 33750 covers

The surgeon creates a connection from the subclavian artery to a pulmonary artery to augment blood flow to the lungs. This palliative operation is used for selected congenital heart conditions with inadequate pulmonary blood flow, including some forms of pulmonary atresia or tetralogy of Fallot. It is generally performed by a congenital cardiothoracic surgeon in an operating room, often for an infant or child awaiting further repair or as part of a staged treatment plan.

Report the procedure when the operative record supports the subclavian-to-pulmonary-artery route; the congenital diagnosis alone does not establish this code. Documentation should identify the vessels connected and describe the shunt performed. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

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 33750 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

33750 office and facility rates by payment locality
Payment localityOfficeFacility
Austin, TXUnavailable$1,190.81
Beaumont, TXUnavailable$1,154.58
Brazoria, TXUnavailable$1,156.56
Dallas, TXUnavailable$1,172.92
Fort Worth, TXUnavailable$1,172.41
Galveston, TXUnavailable$1,165.88
Houston, TXUnavailable$1,265.63
Rest of TexasUnavailable$1,161.07

How the 33750 rate is calculated

Each of 33750’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 · 33750

RVUs × geographic indexes × conversion factor

Office or facility?

Work21.66

21.66 RVUs× 1.000 GPCI

Practice expense8.62

8.62 RVUs× 1.000 GPCI

Malpractice5.45

5.45 RVUs× 1.000 GPCI

Adjusted RVUs

35.7300

Conversion factor

$33.4009

Medicare rate

$1,193.41

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

Payment rules and modifiers for 33750

33750 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 33750

Systemic-to-pulmonary shunt, subclavian artery connection

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)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.84/0.07Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 33750

Systemic-to-pulmonary shunt, subclavian artery connection

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

33750 without 51 · national facility

$1,193.41

Systemic-to-pulmonary shunt, subclavian artery connection

33750-51 · Second procedure: 50%

$596.71

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

33750 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 33750

    Systemic-to-pulmonary shunt, subclavian artery connection21.66 wRVU

    Not priced

  • 33755

    Systemic-pulmonary shunt, ascending aorta origin22.04 wRVU

    Not priced

  • 33762

    Systemic-to-pulmonary shunt, potts-Smith route22.04 wRVU

    Not priced

  • 33764

    Systemic-pulmonary shunt, central, prosthetic graft22.04 wRVU

    Not priced

How to choose

33755Systemic-pulmonary shuntAscending aorta origin
Use 33750 for a subclavian-source shunt. Code 33755 describes an aorta-to-pulmonary-artery route.
33762Systemic-to-pulmonary shuntPotts-Smith route
This code is specific to a subclavian source; 33762 identifies the descending aorta as the source.
33764Systemic-pulmonary shuntCentral, prosthetic graft
33764 is for a central shunt with a prosthetic graft. Choose 33750 when the documented shunt uses the subclavian-to-pulmonary-artery route.

33750 billing questions

How is this distinguished from an aorta-to-pulmonary artery shunt?

Select this code when the subclavian artery is the systemic source for the shunt. A shunt originating from the aorta is represented by a different code.

What operative documentation supports this code?

The operative report should identify the subclavian artery and pulmonary artery as the connected vessels and describe the shunt performed.

Can modifier 50 be used for shunts to both lungs?

No. CMS identifies bilateral adjustment as inappropriate for this code. Report the procedure supported by the documented operative anatomy rather than adding modifier 50.

Is an assistant surgeon payable?

CMS indicates that assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and related postoperative care through the 90-day 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 33750PPRRVU2026_Oct_nonQPP.csv, line 4,052 (RVU26D)

Open CMS sourceHow we calculate rates

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