CPT code 33764: Systemic-pulmonary shunt, central, prosthetic graft2026 Medicare rate & RVUs

Reports creation of a central systemic-to-pulmonary artery shunt using a prosthetic graft, typically to increase pulmonary blood flow in congenital heart disease.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $1,262.22 for 33764 nationally in a facility.

Medicare rate · 33764

Systemic-pulmonary shunt, central, prosthetic graft

Office or facility?

Work RVUs
22.04
Total RVUs
37.79
Global days
090

National rate · 2026

$1,262.22

Facility setting, before claim adjustments.

See every locality for 33764 →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 33764 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 33764 covers

A congenital cardiac surgeon creates a central connection from the systemic arterial circulation to the pulmonary artery using a prosthetic graft. The shunt provides additional pulmonary blood flow, often as palliation for a cyanotic congenital heart defect with inadequate flow to the lungs. The procedure is performed in an operating room; the operative report should identify the shunt’s origin and insertion and confirm use of a prosthetic graft.

Select this code for the central graft configuration, rather than choosing by the general goal of increasing pulmonary blood flow alone. Document the anatomy and construction so the central route can be distinguished from named subclavian or aortic shunt routes. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued is paid in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeons require 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 33764 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

33764 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,139.18
AlaskaUnavailable$1,569.21
ArizonaUnavailable$1,224.96
ArkansasUnavailable$1,124.28
Atlanta, GAUnavailable$1,307.14
Austin, TXUnavailable$1,262.32
Bakersfield, CAUnavailable$1,236.43
Baltimore area, MDUnavailable$1,342.80
Beaumont, TXUnavailable$1,218.40
Brazoria, TXUnavailable$1,224.26

33764 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.

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33764 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 33764 rate is calculated

Each of 33764’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 · 33764

RVUs × geographic indexes × conversion factor

Office or facility?

Work22.04

22.04 RVUs× 1.000 GPCI

Practice expense10.20

10.20 RVUs× 1.000 GPCI

Malpractice5.55

5.55 RVUs× 1.000 GPCI

Adjusted RVUs

37.7900

Conversion factor

$33.4009

Medicare rate

$1,262.22

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

Payment rules and modifiers for 33764

33764 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 33764

Systemic-pulmonary shunt, central, prosthetic graft

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 · 33764

Systemic-pulmonary shunt, central, prosthetic graft

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

33764 without 51 · national facility

$1,262.22

Systemic-pulmonary shunt, central, prosthetic graft

33764-51 · Second procedure: 50%

$631.11

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

33764 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 33764

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

    Not priced

  • 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

  • 33766

    Glenn shunt, one lung22.98 wRVU

    Not priced

How to choose

33750Systemic-to-pulmonary shuntSubclavian artery connection
Use 33750 when the shunt originates from the subclavian artery. This code describes a central prosthetic-graft configuration.
33755Systemic-pulmonary shuntAscending aorta origin
33755 identifies an ascending aorta-to-pulmonary artery shunt. Choose this code for the central graft configuration rather than that named route.
33762Systemic-to-pulmonary shuntPotts-Smith route
33762 identifies a descending aorta-to-pulmonary artery shunt. The central prosthetic-graft configuration is reported with this code.
33766Glenn shuntOne lung
33766 is a superior vena cava-to-pulmonary artery shunt for one lung, not a systemic arterial-to-pulmonary artery graft shunt.

33764 billing questions

How is this distinguished from a subclavian-to-pulmonary artery shunt?

This code is for the central shunt configuration using a prosthetic graft. A shunt originating from the subclavian artery is reported with 33750.

What operative details support code selection?

The report should establish the central route, identify the systemic arterial origin and pulmonary artery insertion, and document the prosthetic graft.

Can modifier 50 be used for a bilateral shunt?

No. CMS identifies bilateral adjustment as inappropriate for this code.

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

The day-before preoperative visit and 90 days of related postoperative care are included in the global period.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures are paid at 50% under the standard multiple procedure reduction.

May an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be available. Co-surgeons are paid only with supporting documentation; team surgery is not permitted.

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 33764PPRRVU2026_Oct_nonQPP.csv, line 4,055 (RVU26D)

Open CMS sourceHow we calculate rates

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