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Billing code 33261: Heart ablationMedicare rate & RVUs

Reports extensive open surgical ablation of a ventricular arrhythmogenic focus, including mapping and isolation, when the operative work exceeds a limited ablation.

CMS RVU26DEffective Oct 1, 2026109 payment localities16 Medicare services in 2024

Medicare pays $1,533.77 for 33261 nationally in a facility.

Medicare rate · 33261

Heart ablation

Swap in your local Medicare rate.

Work RVUs
28.2
Total RVUs
45.92
Global days
090

National rate · 2026

$1,533.77

Facility setting, before claim adjustments.

See every locality for 33261 → · 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 33261 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 33261 covers

This code covers extensive surgical treatment of a ventricular arrhythmogenic focus, with mapping and isolation of the tissue responsible for the dysrhythmia. Cardiac surgeons perform it in an operating room, typically for a patient undergoing open heart surgery or treatment of a difficult ventricular arrhythmia. The operative report should identify the ventricular focus and describe the mapping and ablation work that supports an extensive rather than limited procedure.

Select this code based on the extent of ventricular ablation documented, not simply the diagnosis or the presence of another cardiac operation. CMS assigns a 90-day global period, including the day-before preoperative visit and 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 for this code. 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 33261 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

33261 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,390.12
Alaska*Unavailable$1,927.31
ArizonaUnavailable$1,489.95
ArkansasUnavailable$1,372.76
AtlantaUnavailable$1,587.77
AustinUnavailable$1,531.20
BakersfieldUnavailable$1,498.69
Baltimore/Surr. CntysUnavailable$1,629.02
BeaumontUnavailable$1,484.79
BrazoriaUnavailable$1,488.41

33261 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.

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
33261 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 33261 rate is calculated

Each of 33261’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 · 33261

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 28.20Practice expense 10.97Malpractice 6.75

45.9200 adjusted RVUs×$33.4009 conversion factor=$1,533.77

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

Payment rules and modifiers for 33261

33261 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 33261

Heart ablation

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 · 33261

Heart ablation

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

33261 without 51 · national facility

$1,533.77

Heart ablation

33261-51 · Second procedure: 50%

$766.89

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

33261 compared with similar codes

Compare codes

33261 vs 93654 vs 33256: national Medicare rates

Swap in your local Medicare rate.

  • 33261
    Heart ablation · 28.2 wRVU
    —
  • 93654
    VT ablation · 17.65 wRVU
    —
  • 33256
    Atrial ablation · 34.03 wRVU
    —

How to choose

93654VT ablation
93654 describes catheter-based ventricular arrhythmia ablation. Code 33261 is for extensive surgical ablation of a ventricular focus.
33256Atrial ablation
33256 addresses extensive ablation and reconstruction of atrial tissue with cardiopulmonary bypass. Code 33261 concerns an extensive ventricular arrhythmogenic focus.

Codes related to 33261

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

Codes related to 33261
CodeHow it relatesNational office range
Used instead
93654VT ablationCatheter-based ablation for ventricular arrhythmia rather than surgical focus ablation.No office rate
33256Atrial ablationExtensive atrial tissue ablation with cardiopulmonary bypass; this code concerns a ventricular focus.No office rate

33261 billing questions

How does this differ from 33260?

Both codes describe ventricular focus ablation. Use 33261 when the operative documentation supports extensive ablation; 33260 is the limited ventricular procedure.

Does this code describe catheter ablation?

No. This code describes surgical ablation of a ventricular focus. Catheter-based ventricular arrhythmia ablation is represented by 93654.

Can modifier 50 be used for ablation on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 is not appropriate.

May an assistant or co-surgeon be reported?

CMS indicates that an assistant at surgery may be paid. Co-surgeons are paid only when supporting documentation is provided; team surgery is not permitted.

What documentation supports the extensive code?

The operative report should identify the ventricular arrhythmogenic focus and describe the mapping, isolation, and extent of ablation that distinguish the work from a limited ventricular 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 33261PPRRVU2026_Oct_nonQPP.csv, line 3,884 (RVU26D)

Open CMS sourceHow we calculate rates

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