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Billing code 33259: Atrial ablationMedicare rate & RVUs

Reports extensive surgical ablation for atrial fibrillation performed with cardiopulmonary bypass during another cardiac operation, as an add-on to that procedure.

CMS RVU26DEffective Oct 1, 2026109 payment localities5K Medicare services in 2024

Medicare pays $820.99 for 33259 nationally in a facility.

Medicare rate · 33259

Atrial ablation

Swap in your local Medicare rate.

Work RVUs
13.79
Total RVUs
24.58
Global days
ZZZ

National rate · 2026

$820.99

Facility setting, before claim adjustments.

See every locality for 33259 → · 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 33259 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 33259 covers

This add-on covers an extensive surgical lesion set in the atria to treat atrial fibrillation while the patient is undergoing another cardiac operation with cardiopulmonary bypass. A cardiac surgeon typically performs it in the operating room during open-heart surgery, such as mitral valve surgery or coronary artery bypass grafting. The ablation is performed alongside the primary operation rather than as a standalone service.

Report 33259 only with the primary cardiac procedure when the operative record supports extensive atrial ablation and cardiopulmonary bypass. Documentation should identify the atrial ablation performed, its extent, use of bypass, and the primary operation. Distinguish it from limited ablation and extensive ablation without bypass when selecting among related codes. CMS treats this as an add-on: it is billed with a primary procedure and paid within that procedure's global period.

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 33259 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

33259 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$741.27
Alaska*Unavailable$1,017.03
ArizonaUnavailable$797.14
ArkansasUnavailable$731.57
AtlantaUnavailable$848.90
AustinUnavailable$823.52
BakersfieldUnavailable$809.69
Baltimore/Surr. CntysUnavailable$873.08
BeaumontUnavailable$790.69
BrazoriaUnavailable$797.76

33259 rates by state

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

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Local rates. Clear comparisons.

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View every state and territory as a table
33259 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 33259 rate is calculated

Each of 33259’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 · 33259

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 13.79Practice expense 7.43Malpractice 3.36

24.5800 adjusted RVUs×$33.4009 conversion factor=$820.99

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

Payment rules and modifiers for 33259

The CMS indicators that decide how 33259 is paid alongside other services.

CMS payment indicators · 33259

Atrial ablation

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
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.

What modifiers do to the payment

Modifier 80 · payment effect

With and without the modifier

33259 without 80 · national facility

$820.99

Atrial ablation

33259-80 · Assistant: 16%

$131.36

A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.

When to use modifier 80

33259 compared with similar codes

Compare codes

33259 vs 33258 vs 33257 vs 33256: national Medicare rates

Swap in your local Medicare rate.

  • 33259
    Atrial ablation · 13.79 wRVU
    —
  • 33258
    Atrial ablation · 10.73 wRVU
    —
  • 33257
    Atrial ablation · 9.39 wRVU
    —
  • 33256
    Atrial ablation · 34.03 wRVU
    —

How to choose

33258Atrial ablation
Choose 33259 for extensive atrial ablation with cardiopulmonary bypass during another cardiac procedure; 33258 represents the corresponding add-on without bypass.
33257Atrial ablation
33257 is the limited-ablation add-on with bypass. 33259 is for an extensive atrial ablation with bypass.
33256Atrial ablation
Both concern extensive atrial ablation with cardiopulmonary bypass. 33259 is the add-on used during another cardiac procedure; 33256 is the related base procedure code.

Codes related to 33259

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

Codes related to 33259
CodeHow it relatesNational office range
Same family
33257Atrial ablationAdd-on for limited atrial ablation with cardiopulmonary bypass during another cardiac procedure.No office rate
33258Atrial ablationAdd-on for extensive atrial ablation during another cardiac procedure without cardiopulmonary bypass.No office rate
33256Atrial ablationExtensive atrial ablation with bypass; distinguish by the circumstances for reporting the base procedure.No office rate
Primary code
33430Mitral valve replacementMitral valve replacement is an example of a primary cardiac operation performed with this add-on.No office rate
33533Arterial CABGCoronary artery bypass grafting is an example of a primary cardiac operation performed with this add-on.No office rate

33259 billing questions

Can 33259 be billed by itself?

No. It is an add-on for extensive atrial ablation performed with cardiopulmonary bypass during another cardiac procedure, and must be reported with the primary procedure.

How does 33259 differ from 33258?

Both represent extensive atrial ablation as an add-on during another cardiac procedure. 33259 is the choice when cardiopulmonary bypass is used; 33258 is for the corresponding service without bypass.

When is 33257 a better choice?

Use 33257 for limited atrial ablation with cardiopulmonary bypass during another cardiac procedure. 33259 describes an extensive ablation with bypass.

Does cardiopulmonary bypass alone support 33259?

No. The record must support the extensive atrial ablation as well as use of bypass during the primary cardiac operation.

What should the operative report document?

Document the atrial ablation and its extent, whether cardiopulmonary bypass was used, and the concurrent primary cardiac procedure.

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 33259PPRRVU2026_Oct_nonQPP.csv, line 3,882 (RVU26D)

Open CMS sourceHow we calculate rates

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