No office rate
Both are endoscopic surgical ablations without bypass; 33265 represents limited ablation, while 33266 represents extensive ablation.
On this page
CMS RVU26D · Effective 2026-10-01
33265 Atrial ablation Medicare reimbursement rates
Reports limited surgical ablation for atrial fibrillation performed endoscopically without cardiopulmonary bypass, typically using a thoracoscopic approach to create an epicardial lesion set. Compare 33265 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 33265?
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 33265 pays more and less
Cardiac surgery
About 33265: Limited thoracoscopic atrial fibrillation ablation
Reports limited surgical ablation for atrial fibrillation performed endoscopically without cardiopulmonary bypass, typically using a thoracoscopic approach to create an epicardial lesion set.
A cardiothoracic surgeon performs this limited surgical ablation through an endoscopic, typically thoracoscopic, approach without cardiopulmonary bypass. The surgeon accesses the atria from outside the heart and creates lesions intended to interrupt atrial fibrillation, commonly including pulmonary vein isolation. It is distinct from catheter-based ablation performed inside the heart and from more extensive surgical lesion sets.
Select the code when the operative report supports a limited endoscopic ablation performed without bypass; document the approach, lesion set, and whether bypass was used. The code 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 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 service. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 33265
- 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 RVU23.12 · 60%
- Practice expense (office) RVU9.94 · 26%
- Malpractice RVU5.69 · 15%
457
Medicare services in 2024 · #3644 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.
33265 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
This code describes limited surgical atrial ablation without bypass using a different approach. Use 33265 when the operative service is endoscopic.
No office rate
33255 describes limited surgical atrial ablation with cardiopulmonary bypass; 33265 is the endoscopic limited service without bypass.
See how rates vary across the country
33265 · 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 33265 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 $1170.30 |
| Alaska* | Office Unavailable | Facility $1616.65 |
| Arizona | Office Unavailable | Facility $1256.63 |
| Arkansas | Office Unavailable | Facility $1155.30 |
| Atlanta | Office Unavailable | Facility $1340.11 |
| Austin | Office Unavailable | Facility $1293.42 |
| Bakersfield | Office Unavailable | Facility $1266.52 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $1375.92 |
| Beaumont | Office Unavailable | Facility $1250.91 |
| Brazoria | Office Unavailable | Facility $1255.66 |
| Chicago | Office Unavailable | Facility $1547.47 |
| Chico | Office Unavailable | Facility $1251.10 |
| Colorado | Office Unavailable | Facility $1283.18 |
| Connecticut | Office Unavailable | Facility $1375.20 |
| Dallas | Office Unavailable | Facility $1272.92 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $1416.56 |
| Delaware | Office Unavailable | Facility $1274.97 |
| Detroit | Office Unavailable | Facility $1413.04 |
| East St. Louis | Office Unavailable | Facility $1460.44 |
| El Centro | Office Unavailable | Facility $1252.05 |
| Fort Lauderdale | Office Unavailable | Facility $1452.16 |
| Fort Worth | Office Unavailable | Facility $1272.07 |
| Fresno | Office Unavailable | Facility $1251.10 |
| Galveston | Office Unavailable | Facility $1265.45 |
| Hanford-Corcoran | Office Unavailable | Facility $1251.10 |
| Hawaii, Guam | Office Unavailable | Facility $1259.76 |
| Houston | Office Unavailable | Facility $1369.60 |
| Idaho | Office Unavailable | Facility $1167.57 |
| Indiana | Office Unavailable | Facility $1172.36 |
| Iowa | Office Unavailable | Facility $1151.46 |
| Kansas | Office Unavailable | Facility $1168.15 |
| Kentucky | Office Unavailable | Facility $1241.28 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $1322.85 |
| Madera | Office Unavailable | Facility $1251.10 |
| Manhattan | Office Unavailable | Facility $1508.86 |
| Merced | Office Unavailable | Facility $1251.10 |
| Metropolitan Boston | Office Unavailable | Facility $1369.45 |
| Metropolitan Kansas City | Office Unavailable | Facility $1269.66 |
| Metropolitan Philadelphia | Office Unavailable | Facility $1358.48 |
| Metropolitan St. Louis | Office Unavailable | Facility $1278.73 |
| Miami | Office Unavailable | Facility $1598.49 |
| Minnesota | Office Unavailable | Facility $1170.12 |
| Mississippi | Office Unavailable | Facility $1198.53 |
| Modesto | Office Unavailable | Facility $1251.10 |
| Montana** | Office Unavailable | Facility $1293.90 |
| Napa | Office Unavailable | Facility $1355.01 |
| Nebraska | Office Unavailable | Facility $1150.51 |
| Nevada** | Office Unavailable | Facility $1262.88 |
| New Hampshire | Office Unavailable | Facility $1284.14 |
| New Mexico | Office Unavailable | Facility $1304.93 |
| New Orleans | Office Unavailable | Facility $1300.54 |
| North Carolina | Office Unavailable | Facility $1203.43 |
| North Dakota** | Office Unavailable | Facility $1181.39 |
| Northern Nj | Office Unavailable | Facility $1408.98 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $1569.33 |
| Ohio | Office Unavailable | Facility $1266.92 |
| Oklahoma | Office Unavailable | Facility $1216.38 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $1304.68 |
| Portland | Office Unavailable | Facility $1294.84 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $1400.49 |
| Puerto Rico | Office Unavailable | Facility $1295.09 |
| Queens | Office Unavailable | Facility $1488.14 |
| Redding | Office Unavailable | Facility $1251.10 |
| Rest Of California | Office Unavailable | Facility $1251.10 |
| Rest Of Florida | Office Unavailable | Facility $1375.27 |
| Rest Of Georgia | Office Unavailable | Facility $1294.92 |
| Rest Of Illinois | Office Unavailable | Facility $1372.40 |
| Rest Of Louisiana | Office Unavailable | Facility $1248.12 |
| Rest Of Maine | Office Unavailable | Facility $1195.89 |
| Rest Of Maryland | Office Unavailable | Facility $1290.41 |
| Rest Of Massachusetts | Office Unavailable | Facility $1285.66 |
| Rest Of Michigan | Office Unavailable | Facility $1289.92 |
| Rest Of Missouri | Office Unavailable | Facility $1243.53 |
| Rest Of New Jersey | Office Unavailable | Facility $1374.15 |
| Rest Of New York | Office Unavailable | Facility $1221.24 |
| Rest Of Oregon | Office Unavailable | Facility $1236.51 |
| Rest Of Pennsylvania | Office Unavailable | Facility $1256.61 |
| Rest Of Texas | Office Unavailable | Facility $1258.92 |
| Rest Of Washington | Office Unavailable | Facility $1276.50 |
| Rhode Island | Office Unavailable | Facility $1299.39 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $1312.12 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $1288.02 |
| Salinas | Office Unavailable | Facility $1282.83 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $1295.48 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $1400.95 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $1394.49 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $1437.79 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $1411.38 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $1265.38 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $1293.70 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $1282.84 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $1304.97 |
| Seattle (King Cnty) | Office Unavailable | Facility $1373.48 |
| South Carolina | Office Unavailable | Facility $1240.54 |
| South Dakota** | Office Unavailable | Facility $1168.09 |
| Southern Maine | Office Unavailable | Facility $1221.17 |
| Stockton | Office Unavailable | Facility $1251.10 |
| Suburban Chicago | Office Unavailable | Facility $1455.37 |
| Tennessee | Office Unavailable | Facility $1176.08 |
| Utah | Office Unavailable | Facility $1254.98 |
| Vallejo | Office Unavailable | Facility $1345.70 |
| Vermont | Office Unavailable | Facility $1197.08 |
| Virgin Islands | Office Unavailable | Facility $1295.09 |
| Virginia | Office Unavailable | Facility $1232.77 |
| Visalia | Office Unavailable | Facility $1251.10 |
| West Virginia | Office Unavailable | Facility $1332.70 |
| Wisconsin | Office Unavailable | Facility $1148.83 |
| Wyoming** | Office Unavailable | Facility $1244.87 |
| Yuba City | Office Unavailable | Facility $1251.10 |
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33265 billing questions
How is 33265 distinguished from 33266?
Both describe endoscopic surgical ablation without cardiopulmonary bypass. Choose 33265 for a limited lesion set and 33266 when the documented surgical ablation is extensive.
How does 33265 differ from 33254?
The key distinction is the endoscopic approach represented by 33265. Use the code that matches the operative approach and documented extent of ablation.
What documentation supports the limited service?
The operative report should identify the endoscopic approach, the ablation performed and its extent, and whether cardiopulmonary bypass was used.
Can modifier 50 be reported?
No. The descriptor and anatomy make this a nonbilateral service, so modifier 50 is inappropriate.
How does the 90-day global period affect postoperative reporting?
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 paid for this procedure?
An assistant at surgery may be paid. Co-surgeon payment requires 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 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.
3,88533262,,Rmvl& replc pulse gen 1 lead,A,,5.66,2.87,NA,2.87,,1.33,9.86,9.86,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,88633263,,Rmvl & rplcmt dfb gen 2 lead,A,,5.93,2.92,NA,2.92,,1.40,10.25,10.25,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,88733264,,Rmvl & rplcmt dfb gen mlt ld,A,,6.19,2.99,NA,2.99,,1.46,10.64,10.64,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,88833265,,Ablate atria lmtd endo,A,,23.12,9.94,NA,9.94,,5.69,38.75,38.75,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,88933266,,Ablate atria x10sv endo,A,,32.21,11.93,NA,11.93,,7.98,52.12,52.12,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,89033267,,Excl laa open any method,A,,18.04,7.13,NA,7.13,,4.43,29.60,29.60,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,89133268,,Excl laa opn oth px any meth,A,,2.44,0.48,NA,0.48,,0.59,3.51,3.51,0,ZZZ,0.00,0.00,0.00,0,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00