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Billing code 33019: Pericardial drainageMedicare rate & RVUs

Report CT-guided percutaneous pericardial drainage when a clinician places an indwelling catheter to drain pericardial fluid through a needle-created access.

CMS RVU26DEffective Oct 1, 2026109 payment localities227 Medicare services in 2024

Medicare pays $179.36 for 33019 nationally in a facility.

Medicare rate · 33019

Pericardial drainage

Swap in your local Medicare rate.

Work RVUs
4.18
Total RVUs
5.37
Global days
000

National rate · 2026

$179.36

Facility setting, before claim adjustments.

See every locality for 33019 → · 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.

On this page 10 sections
  1. Medicare rate
  2. What 33019 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 33019 covers

This service involves accessing the pericardial space through the chest wall under CT guidance and leaving an indwelling catheter to drain fluid, such as an effusion associated with cardiac tamponade. It is typically performed by a cardiologist, interventional radiologist, or other physician experienced in percutaneous image-guided procedures in a hospital or other facility. The catheter permits ongoing drainage rather than a single needle aspiration.

Report 33019 when the documented service includes percutaneous catheter placement and CT guidance. The procedure note should identify the indication, CT-guided access, catheter placement, and drainage performed. Imaging guidance is included in the service. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate; assistant-at-surgery services are not paid, and co-surgeons and team surgery are 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 33019 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

33019 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$169.13
Alaska*Unavailable$243.00
ArizonaUnavailable$176.21
ArkansasUnavailable$167.90
AtlantaUnavailable$183.57
AustinUnavailable$179.02
BakersfieldUnavailable$177.54
Baltimore/Surr. CntysUnavailable$187.29
BeaumontUnavailable$176.11
BrazoriaUnavailable$176.53

33019 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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
33019 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 33019 rate is calculated

Each of 33019’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 · 33019

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 4.18Practice expense 0.68Malpractice 0.51

5.3700 adjusted RVUs×$33.4009 conversion factor=$179.36

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 33019

The CMS indicators that decide how 33019 is paid alongside other services.

CMS payment indicators · 33019

Pericardial drainage

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is 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)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

33019 without 51 · national facility

$179.36

Pericardial drainage

33019-51 · Second procedure: 50%

$89.68

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

33019 compared with similar codes

Compare codes

33019 vs 33016 vs 33017 vs 33018 vs 33025: national Medicare rates

Swap in your local Medicare rate.

  • 33019
    Pericardial drainage · 4.18 wRVU
    —
  • 33016
    Pericardiocentesis · 4.29 wRVU
    —
  • 33017
    Pericardial drainage · 4.5 wRVU
    —
  • 33018
    Pericardial drainage · 5.27 wRVU
    —
  • 33025
    Pericardial window · 12.87 wRVU
    —

How to choose

33016Pericardiocentesis
Use 33019 for CT-guided percutaneous drainage with an indwelling catheter. Use 33016 for pericardiocentesis, including imaging guidance, when a catheter-drainage service is not performed.
33017Pericardial drainage
33017 is for percutaneous catheter drainage in patients age 6 years or older without congenital cardiac anomaly. 33019 identifies the CT-guided service.
33018Pericardial drainage
33018 is for percutaneous catheter drainage in patients age 0–5 years or with congenital cardiac anomaly. 33019 identifies the CT-guided service.
33025Pericardial window
33025 describes creation of a pericardial window for drainage. 33019 is the percutaneous CT-guided catheter approach.

Codes related to 33019

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

Codes related to 33019
CodeHow it relatesNational office range
Used instead
33016PericardiocentesisPericardiocentesis, including imaging guidance, rather than catheter drainage under CT guidance.No office rate
33017Pericardial drainageRelated percutaneous catheter drainage code for patients age 6 years or older without congenital cardiac anomaly.No office rate
33018Pericardial drainageRelated percutaneous catheter drainage code for patients age 0–5 years or with congenital cardiac anomaly.No office rate
33020PericardiotomyPericardial incision approach, unlike percutaneous CT-guided catheter placement.No office rate
33025Pericardial windowPericardial window approach for drainage rather than percutaneous catheter placement.No office rate

33019 billing questions

When should 33019 be selected instead of 33016?

33019 describes percutaneous drainage with an indwelling catheter under CT guidance. 33016 describes pericardiocentesis, which may involve aspiration without leaving a catheter.

Is CT guidance separately reported with 33019?

No. The imaging guidance is included in this service; do not separately report the same CT guidance used to place the catheter.

How does 33019 differ from 33017 and 33018?

33019 identifies CT-guided catheter drainage. Codes 33017 and 33018 describe related percutaneous catheter drainage services distinguished by patient age and congenital cardiac anomaly criteria.

Can modifier 50 be appended for drainage on both sides?

No. The CMS bilateral adjustment does not apply to 33019, and modifier 50 is inappropriate for this service.

What payment rules apply when another procedure is performed in the same session?

The highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Same-day preoperative and postoperative care is included in the 0-day global period.

Can an assistant, co-surgeon, or surgical team be paid for 33019?

Assistant-at-surgery payment is barred for this code. Co-surgeons and team surgery are 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 33019PPRRVU2026_Oct_nonQPP.csv, line 3,817 (RVU26D)

Open CMS sourceHow we calculate rates

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