No office rate
Use 33031 when cardiopulmonary bypass supports the pericardiectomy; use 33030 when the operation is performed without bypass.
On this page
CMS RVU26D · Effective 2026-10-01
33031 Pericardiectomy Medicare reimbursement rates
Reports surgical removal of part or most of the pericardium with cardiopulmonary bypass, commonly for constrictive disease requiring operative treatment. Compare 33031 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 33031?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 33031 pays more and less
Cardiothoracic surgery
About 33031: Pericardiectomy with cardiopulmonary bypass
Reports surgical removal of part or most of the pericardium with cardiopulmonary bypass, commonly for constrictive disease requiring operative treatment.
A cardiothoracic surgeon removes diseased, thickened, or constricting pericardium while the patient is supported with cardiopulmonary bypass. The operation is typically performed in a hospital operating room for conditions such as constrictive pericarditis when a limited drainage opening would not address the disease. The operative report should establish the extent of pericardial removal and use of bypass.
Choose this code when the documented pericardiectomy is performed with cardiopulmonary bypass; the sibling code 33030 describes the operation without bypass. 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 procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate because the pericardium is not paired right-left anatomy. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 33031
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU43.88 · 63%
- Practice expense (office) RVU14.45 · 21%
- Malpractice RVU10.88 · 16%
219
Medicare services in 2024 · #4246 by national volume
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.
33031 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
33025 represents a pericardial window or limited resection for drainage. 33031 represents pericardiectomy with bypass, not drainage alone.
No office rate
33016 is pericardiocentesis with imaging for fluid drainage; 33031 is surgical removal of pericardium with bypass.
No office rate
33050 is used for excision of a pericardial cyst or tumor; 33031 is pericardiectomy for removal of diseased or constricting pericardium.
See how rates vary across the country
33031 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Compare 33031 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office Unavailable | Facility $2093.63 |
| Alaska* | Office Unavailable | Facility $2912.70 |
| Arizona | Office Unavailable | Facility $2244.38 |
| Arkansas | Office Unavailable | Facility $2067.37 |
| Atlanta | Office Unavailable | Facility $2396.84 |
| Austin | Office Unavailable | Facility $2301.17 |
| Bakersfield | Office Unavailable | Facility $2243.77 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $2456.49 |
| Beaumont | Office Unavailable | Facility $2242.44 |
| Brazoria | Office Unavailable | Facility $2239.11 |
| Chicago | Office Unavailable | Facility $2794.95 |
| Chico | Office Unavailable | Facility $2214.31 |
| Colorado | Office Unavailable | Facility $2280.57 |
| Connecticut | Office Unavailable | Facility $2454.47 |
| Dallas | Office Unavailable | Facility $2271.33 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $2517.80 |
| Delaware | Office Unavailable | Facility $2276.51 |
| Detroit | Office Unavailable | Facility $2544.08 |
| East St. Louis | Office Unavailable | Facility $2641.55 |
| El Centro | Office Unavailable | Facility $2216.12 |
| Fort Lauderdale | Office Unavailable | Facility $2611.58 |
| Fort Worth | Office Unavailable | Facility $2271.23 |
| Fresno | Office Unavailable | Facility $2214.31 |
| Galveston | Office Unavailable | Facility $2257.52 |
| Hanford-Corcoran | Office Unavailable | Facility $2214.31 |
| Hawaii, Guam | Office Unavailable | Facility $2224.81 |
| Houston | Office Unavailable | Facility $2456.66 |
| Idaho | Office Unavailable | Facility $2081.55 |
| Indiana | Office Unavailable | Facility $2089.65 |
| Iowa | Office Unavailable | Facility $2051.52 |
| Kansas | Office Unavailable | Facility $2085.10 |
| Kentucky | Office Unavailable | Facility $2227.21 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $2337.99 |
| Madera | Office Unavailable | Facility $2214.31 |
| Manhattan | Office Unavailable | Facility $2696.62 |
| Merced | Office Unavailable | Facility $2214.31 |
| Metropolitan Boston | Office Unavailable | Facility $2425.43 |
| Metropolitan Kansas City | Office Unavailable | Facility $2273.88 |
| Metropolitan Philadelphia | Office Unavailable | Facility $2427.98 |
| Metropolitan St. Louis | Office Unavailable | Facility $2289.24 |
| Miami | Office Unavailable | Facility $2887.11 |
| Minnesota | Office Unavailable | Facility $2069.84 |
| Mississippi | Office Unavailable | Facility $2149.74 |
| Modesto | Office Unavailable | Facility $2214.31 |
| Montana** | Office Unavailable | Facility $2310.95 |
| Napa | Office Unavailable | Facility $2378.70 |
| Nebraska | Office Unavailable | Facility $2048.48 |
| Nevada** | Office Unavailable | Facility $2251.47 |
| New Hampshire | Office Unavailable | Facility $2286.04 |
| New Mexico | Office Unavailable | Facility $2344.66 |
| New Orleans | Office Unavailable | Facility $2332.62 |
| North Carolina | Office Unavailable | Facility $2148.15 |
| North Dakota** | Office Unavailable | Facility $2095.82 |
| Northern Nj | Office Unavailable | Facility $2505.95 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $2808.13 |
| Ohio | Office Unavailable | Facility $2272.59 |
| Oklahoma | Office Unavailable | Facility $2178.99 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $2303.55 |
| Portland | Office Unavailable | Facility $2295.67 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $2499.80 |
| Puerto Rico | Office Unavailable | Facility $2311.53 |
| Queens | Office Unavailable | Facility $2653.94 |
| Redding | Office Unavailable | Facility $2214.31 |
| Rest Of California | Office Unavailable | Facility $2214.31 |
| Rest Of Florida | Office Unavailable | Facility $2473.23 |
| Rest Of Georgia | Office Unavailable | Facility $2329.32 |
| Rest Of Illinois | Office Unavailable | Facility $2474.28 |
| Rest Of Louisiana | Office Unavailable | Facility $2240.91 |
| Rest Of Maine | Office Unavailable | Facility $2135.70 |
| Rest Of Maryland | Office Unavailable | Facility $2302.33 |
| Rest Of Massachusetts | Office Unavailable | Facility $2286.94 |
| Rest Of Michigan | Office Unavailable | Facility $2316.57 |
| Rest Of Missouri | Office Unavailable | Facility $2235.62 |
| Rest Of New Jersey | Office Unavailable | Facility $2449.95 |
| Rest Of New York | Office Unavailable | Facility $2179.61 |
| Rest Of Oregon | Office Unavailable | Facility $2201.82 |
| Rest Of Pennsylvania | Office Unavailable | Facility $2252.11 |
| Rest Of Texas | Office Unavailable | Facility $2251.81 |
| Rest Of Washington | Office Unavailable | Facility $2269.46 |
| Rhode Island | Office Unavailable | Facility $2316.20 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $2330.97 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $2274.49 |
| Salinas | Office Unavailable | Facility $2265.23 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $2283.81 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $2452.19 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $2439.84 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $2517.61 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $2467.09 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $2235.06 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $2277.60 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $2264.21 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $2297.07 |
| Seattle (King Cnty) | Office Unavailable | Facility $2428.02 |
| South Carolina | Office Unavailable | Facility $2220.49 |
| South Dakota** | Office Unavailable | Facility $2070.38 |
| Southern Maine | Office Unavailable | Facility $2173.24 |
| Stockton | Office Unavailable | Facility $2214.31 |
| Suburban Chicago | Office Unavailable | Facility $2615.51 |
| Tennessee | Office Unavailable | Facility $2099.50 |
| Utah | Office Unavailable | Facility $2245.65 |
| Vallejo | Office Unavailable | Facility $2360.89 |
| Vermont | Office Unavailable | Facility $2127.33 |
| Virgin Islands | Office Unavailable | Facility $2311.53 |
| Virginia | Office Unavailable | Facility $2196.63 |
| Visalia | Office Unavailable | Facility $2214.31 |
| West Virginia | Office Unavailable | Facility $2405.08 |
| Wisconsin | Office Unavailable | Facility $2039.93 |
| Wyoming** | Office Unavailable | Facility $2217.19 |
| Yuba City | Office Unavailable | Facility $2214.31 |
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
33031 billing questions
How does 33031 differ from 33030?
Both describe subtotal or complete pericardial removal. Report 33031 when cardiopulmonary bypass is used; 33030 is the corresponding service without bypass.
Is a pericardial window reported with 33031?
A pericardial window or limited resection for drainage is represented by 33025, not by treating part of the pericardiectomy as a separate window. The operative documentation should clarify the procedure performed.
What documentation supports 33031?
The operative report should describe the pericardial removal and document cardiopulmonary bypass use. It should make clear that the service was a pericardiectomy rather than drainage alone.
Can modifier 50 be used?
No. Modifier 50 is inappropriate because pericardiectomy involves the heart sac, not a paired right and left structure.
How are assistant and co-surgeon services handled?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation, and team surgery is not permitted for this code.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, with other procedures subject to the standard multiple-procedure reduction to 50%.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
3,81933020,,Incision of heart sac,A,,13.95,6.10,NA,6.10,,3.41,23.46,23.46,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,82033025,,Incision of heart sac,A,,12.87,6.11,NA,6.11,,3.18,22.16,22.16,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,82133030,,Partial removal of heart sac,A,,35.10,12.42,NA,12.42,,8.70,56.22,56.22,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,82233031,,Partial removal of heart sac,A,,43.88,14.45,NA,14.45,,10.88,69.21,69.21,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,82333050,,Resect heart sac lesion,A,,16.55,8.30,NA,8.30,,4.17,29.02,29.02,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,82433120,,Exc icar tum resc w/card byp,A,,37.49,11.70,NA,11.70,,9.24,58.43,58.43,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,82533130,,Rescj external cardiac tumor,A,,23.57,10.02,NA,10.02,,5.63,39.22,39.22,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00