FeeBase
Log inGet started
Menu

Billing code 33140: Heart revascularizationMedicare rate & RVUs

Reports laser-created channels in the heart muscle through thoracotomy when transmyocardial revascularization is performed as a standalone operation.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $1,473.31 for 33140 nationally in a facility.

Medicare rate · 33140

Heart revascularization

Work RVUs
27.63
Total RVUs
44.11
Global days
090

National rate · 2026

$1,473.31

Facility setting, before claim adjustments.

See every locality for 33140 →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 33140 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 33140 covers

A cardiothoracic surgeon performs transmyocardial laser revascularization through a thoracotomy, creating channels in the heart muscle to address severe angina in selected patients whose coronary disease is not suitable for conventional revascularization. The procedure is performed in an operating room. This code is for TMR performed as a standalone operation; when TMR accompanies another cardiac operation, the separate code for that circumstance is 33141.

Report 33140 when the operative record supports standalone TMR and documents the thoracotomy and laser treatment. The 90-day 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 the others at 50%. Bilateral adjustment is not appropriate. Assistant-at-surgery payment may be made; 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 33140 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

33140 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,336.29
Alaska*Unavailable$1,857.05
ArizonaUnavailable$1,431.30
ArkansasUnavailable$1,319.75
AtlantaUnavailable$1,525.73
AustinUnavailable$1,469.11
BakersfieldUnavailable$1,436.17
Baltimore/Surr. CntysUnavailable$1,564.47
BeaumontUnavailable$1,427.97
BrazoriaUnavailable$1,429.16

33140 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
33140 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 33140 rate is calculated

Each of 33140’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 · 33140

RVUs × geographic indexes × conversion factor

Work27.63

27.63 RVUs× 1.000 GPCI

Practice expense9.87

9.87 RVUs× 1.000 GPCI

Malpractice6.61

6.61 RVUs× 1.000 GPCI

Adjusted RVUs

44.1100

Conversion factor

$33.4009

Medicare rate

$1,473.31

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

Payment rules and modifiers for 33140

33140 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 33140

Heart revascularization

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)0Not permitted.
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 · 33140

Heart revascularization

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

33140 without 51 · national facility

$1,473.31

Heart revascularization

33140-51 · Second procedure: 50%

$736.66

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

33140 compared with similar codes

Compare codes · National

4 codes, side by side

  • 33140

    Heart revascularization27.63 wRVU

    Not priced

  • 33141

    Heart revascularization2.48 wRVU

    Not priced

  • 33533

    Arterial CABG32.91 wRVU

    Not priced

  • 92920

    Coronary angioplasty8.14 wRVU

    Not priced

How to choose

33141Heart revascularization
33140 is for standalone TMR through thoracotomy. 33141 is used when TMR is performed during another cardiac procedure.
33533Arterial CABG
33533 describes coronary bypass using one arterial graft. It is a bypass operation, not laser channel creation in the heart muscle.
92920Coronary angioplasty
92920 describes percutaneous coronary angioplasty of one major artery or branch. It uses a catheter-based approach rather than thoracotomy and TMR.

Codes related to 33140

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

Codes related to 33140
CodeHow it relatesNational office range
Used instead
33141Heart revascularizationUse for TMR performed during another cardiac procedure rather than as a standalone operation.No office rate
33533Arterial CABGDescribes coronary bypass using one arterial graft, a different revascularization method.No office rate
92920Coronary angioplastyDescribes coronary angioplasty for a single major coronary artery or branch, rather than surgical TMR.No office rate

33140 billing questions

When should 33140 be chosen instead of 33141?

Use 33140 for TMR performed as a standalone operation. Use 33141 when TMR is performed during another cardiac procedure.

Can TMR be reported with a coronary bypass procedure?

When TMR is performed during a bypass or another cardiac operation, 33141 describes that TMR circumstance; 33140 is for standalone TMR.

Does modifier 50 apply to 33140?

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

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

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

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeons and team surgery are not permitted for this code.

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 33140PPRRVU2026_Oct_nonQPP.csv, line 3,826 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 33140 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 33140 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 →