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CPT code 33999: Unlisted cardiac surgery, unlisted procedure2026 Medicare rate & RVUs

Reports a cardiac surgical service when no listed CPT code accurately describes the operation performed.

CMS RVU26DEffective Oct 1, 2026109 payment localities3.1K Medicare services in 2024

Medicare rate · 33999

Unlisted cardiac surgery, unlisted procedure

Office or facility?

Work RVUs
0
Total RVUs
0.00
Global days
YYY

National rate · 2026

—

Not priced in the facility setting.

See every locality for 33999 →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 33999 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 33999 covers

This code is for a cardiac operation that lacks a specific CPT code describing the work performed. It may be reported by the cardiac surgeon when the operative service does not fit a listed procedure, including the specific device or approach codes available for some heart procedures. It is not a substitute for a listed code that accurately represents the operation. The operative report should explain the procedure, approach, extent of work, and why no specific code fits; a comparable listed service can help the Medicare contractor assess the claim.

Medicare assigns this code physician fee schedule status C, or carrier priced: CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim. The contractor also sets the global period. When multiple procedures occur in the same session, the standard multiple procedure reduction pays the highest-valued procedure in full and others at 50%.

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 33999 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

33999 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

33999 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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
33999 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 33999 rate is calculated

Each of 33999’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 · 33999

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.00

0.00 RVUs× 1.000 GPCI

Practice expense0.00

0.00 RVUs× 1.000 GPCI

Malpractice0.00

0.00 RVUs× 1.000 GPCI

Adjusted RVUs

0.0000

Conversion factor

$33.4009

Medicare rate

$0.00

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

Payment rules and modifiers for 33999

The CMS indicators that decide how 33999 is paid alongside other services.

CMS payment indicators · 33999

Unlisted cardiac surgery, unlisted procedure

RuleCMS valueWhat it means
Global periodYYYThe Medicare contractor sets the global period.
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)1Permitted with supporting documentation.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

33999 without 51 · national facility

$0.00

Unlisted cardiac surgery, unlisted procedure

33999-51 · Second procedure: 50%

$0.00

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

33999 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 33999

    Unlisted cardiac surgery, unlisted procedure0 wRVU

    Not priced

  • 33975

    Ventricular assist device, extracorporeal, biventricular24.38 wRVU

    Not priced

  • 33979

    Ventricular assist device, implantable, single ventricle36.56 wRVU

    Not priced

  • 33990

    VAD insertion, left heart, arterial access6.58 wRVU

    Not priced

How to choose

33975Ventricular assist deviceExtracorporeal, biventricular
33975 describes a specific ventricular assist device procedure. Report 33999 only when the cardiac operation performed is not represented by that or another listed code.
33979Ventricular assist deviceImplantable, single ventricle
33979 identifies a specific intracorporeal ventricular assist device procedure; 33999 is for a cardiac operation without a matching listed CPT code.
33990VAD insertionLeft heart, arterial access
33990 is a specific percutaneous left-heart assist-device code. Choose 33999 only if the operation does not fit that code or another listed procedure.

Codes related to 33999

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

Codes related to 33999
CodeHow it relatesNational office range
Used instead
33975Ventricular assist device, extracorporeal, biventricularUse this listed ventricular assist device code when its defined procedure matches the operation.No office rate
33979Ventricular assist device, implantable, single ventricleA specific intracorporeal ventricular assist device procedure may fit this code instead.No office rate
33990VAD insertion, left heart, arterial accessUse this specific percutaneous left-heart assist-device code when it describes the service.No office rate

33999 billing questions

When should a surgeon report 33999 instead of a listed cardiac surgery code?

Use 33999 only when no listed CPT code accurately describes the cardiac operation. If a specific procedure code fits the work performed, report that code instead.

What documentation supports a 33999 claim?

The operative report should describe the approach, operative work, and extent of the service, and explain why a listed code does not fit. A comparable listed procedure can help the contractor evaluate the claim.

How does Medicare price 33999?

It has physician fee schedule status C, or carrier priced. CMS publishes no national payment; the Medicare Administrative Contractor sets payment for each claim.

Who determines the global period for 33999?

The Medicare contractor sets the global period for this unlisted cardiac surgery code.

How is 33999 treated when other procedures occur in the same session?

The standard multiple procedure reduction pays the highest-valued procedure in full and other procedures at 50% when performed in the same session.

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

Open CMS sourceHow we calculate rates

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