FeeBase
Log inGet started
Menu

Billing code 33020: PericardiotomyMedicare rate & RVUs

Reports surgical opening of the pericardium to remove a clot or foreign body, including cases performed with or without cardiopulmonary bypass.

CMS RVU26DEffective Oct 1, 2026109 payment localities172 Medicare services in 2024

Medicare pays $783.59 for 33020 nationally in a facility.

Medicare rate · 33020

Pericardiotomy

Work RVUs
13.95
Total RVUs
23.46
Global days
090

National rate · 2026

$783.59

Facility setting, before claim adjustments.

See every locality for 33020 →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 33020 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 33020 covers

A cardiac or thoracic surgeon opens the pericardium to remove a clot or foreign body, such as retained material causing compression around the heart. This is an operative service, commonly performed in a hospital operating room when the problem requires direct surgical access rather than needle or catheter drainage. The procedure may be performed with or without cardiopulmonary bypass.

Report the code when the operative record supports pericardial incision for clot or foreign-body removal; a pericardial window for effusion or pericardial tissue resection is a different service. The major-surgery global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate. An assistant at surgery may be paid; 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 33020 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

33020 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$708.69
Alaska*Unavailable$978.66
ArizonaUnavailable$760.87
ArkansasUnavailable$699.62
AtlantaUnavailable$811.14
AustinUnavailable$783.35
BakersfieldUnavailable$767.46
Baltimore/Surr. CntysUnavailable$832.91
BeaumontUnavailable$757.16
BrazoriaUnavailable$760.42

33020 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
33020 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 33020 rate is calculated

Each of 33020’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 · 33020

RVUs × geographic indexes × conversion factor

Work13.95

13.95 RVUs× 1.000 GPCI

Practice expense6.10

6.10 RVUs× 1.000 GPCI

Malpractice3.41

3.41 RVUs× 1.000 GPCI

Adjusted RVUs

23.4600

Conversion factor

$33.4009

Medicare rate

$783.59

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

Payment rules and modifiers for 33020

33020 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 33020

Pericardiotomy

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 · 33020

Pericardiotomy

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

33020 without 51 · national facility

$783.59

Pericardiotomy

33020-51 · Second procedure: 50%

$391.80

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

33020 compared with similar codes

Compare codes · National

4 codes, side by side

  • 33020

    Pericardiotomy13.95 wRVU

    Not priced

  • 33016

    Pericardiocentesis4.29 wRVU

    Not priced

  • 33017

    Pericardial drainage4.5 wRVU

    Not priced

  • 33025

    Pericardial window12.87 wRVU

    Not priced

How to choose

33016Pericardiocentesis
33020 involves surgical access to remove a clot or foreign body. 33016 is image-guided needle drainage of pericardial fluid.
33017Pericardial drainage
33017 provides catheter-based pericardial drainage for the specified age and congenital-anomaly group. 33020 is an operative incision for clot or foreign-body removal.
33025Pericardial window
33025 creates a pericardial window or partially resects tissue for drainage. Use 33020 when the operation is for removal of a clot or foreign body.

Codes related to 33020

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

Codes related to 33020
CodeHow it relatesNational office range
Used instead
33016PericardiocentesisNeedle pericardiocentesis with imaging guidance for pericardial fluid drainage.No office rate
33017Pericardial drainageCatheter-based pericardial drainage for patients age 6 years or older without congenital cardiac anomaly.No office rate
33019Pericardial drainagePercutaneous catheter drainage with CT guidance, rather than open surgical removal.No office rate
33025Pericardial windowSurgical pericardial window or partial resection for drainage, rather than clot or foreign-body removal.No office rate

33020 billing questions

How does this differ from pericardiocentesis?

This code is for surgical pericardial access to remove a clot or foreign body. Pericardiocentesis uses needle or catheter access to drain pericardial fluid.

Is a pericardial window reported with this code?

A window created to provide drainage is a distinct service, generally represented by 33025. Choose based on the operation documented, not simply the fact that the pericardium was opened.

What documentation supports reporting 33020?

The operative report should establish the pericardial incision and removal of a clot or foreign body. It should also describe the operative approach and whether cardiopulmonary bypass was used.

Can modifier 50 be used?

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

How are other procedures in the same session paid?

Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures performed in the same session are subject to reduction. The code has a 90-day global period for related postoperative care.

May an assistant or co-surgeon be reported?

An assistant at surgery may be paid. 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 33020PPRRVU2026_Oct_nonQPP.csv, line 3,819 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 33020 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 33020 and the rest of your codes on one sheet

Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.

Build my fee sheetOr price your code list free →