No office rate
Both describe endoscopic surgical atrial ablation, but 33265 represents a limited lesion set; 33266 represents an extensive one.
On this page
CMS RVU26D · Effective 2026-10-01
33266 Atrial ablation Medicare reimbursement rates
Reports extensive surgical ablation of atrial tissue through an endoscopic approach, typically for atrial fibrillation when a broader lesion set is performed without cardiopulmonary bypass. Compare 33266 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 33266?
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 33266 pays more and less
Cardiac surgery
About 33266: Extensive endoscopic atrial ablation
Reports extensive surgical ablation of atrial tissue through an endoscopic approach, typically for atrial fibrillation when a broader lesion set is performed without cardiopulmonary bypass.
This code represents extensive surgical ablation of atrial tissue using an endoscopic approach without cardiopulmonary bypass. Cardiac surgeons may perform it for atrial fibrillation using thoracoscopic access to create a broader lesion pattern, such as a maze-type procedure. It describes surgical treatment of atrial tissue, rather than catheter-based ablation inside the heart. The extent of the ablation, not simply the number of access sites, distinguishes it from a limited procedure.
Report the code when the operative record supports an extensive atrial lesion set and the endoscopic approach. Documentation should identify the treatment performed, access method, and whether cardiopulmonary bypass was used. The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery. When other 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 atrial procedure. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 33266
- 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 RVU32.21 · 62%
- Practice expense (office) RVU11.93 · 23%
- Malpractice RVU7.98 · 15%
936
Medicare services in 2024 · #3020 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.
33266 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
Both describe extensive atrial ablation without cardiopulmonary bypass. Choose 33266 for the endoscopic approach and 33255 for the non-endoscopic approach.
No office rate
33256 describes extensive atrial ablation performed with cardiopulmonary bypass; 33266 describes the endoscopic procedure without bypass.
No office rate
33261 treats a dysrhythmogenic focus in the heart. It is not the code for an extensive endoscopic atrial lesion set.
See how rates vary across the country
33266 · 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 33266 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 $1575.37 |
| Alaska* | Office Unavailable | Facility $2185.00 |
| Arizona | Office Unavailable | Facility $1690.12 |
| Arkansas | Office Unavailable | Facility $1555.40 |
| Atlanta | Office Unavailable | Facility $1804.03 |
| Austin | Office Unavailable | Facility $1735.73 |
| Bakersfield | Office Unavailable | Facility $1695.33 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $1850.33 |
| Beaumont | Office Unavailable | Facility $1686.07 |
| Brazoria | Office Unavailable | Facility $1687.24 |
| Chicago | Office Unavailable | Facility $2095.55 |
| Chico | Office Unavailable | Facility $1673.72 |
| Colorado | Office Unavailable | Facility $1720.90 |
| Connecticut | Office Unavailable | Facility $1849.03 |
| Dallas | Office Unavailable | Facility $1711.10 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $1900.00 |
| Delaware | Office Unavailable | Facility $1714.53 |
| Detroit | Office Unavailable | Facility $1909.75 |
| East St. Louis | Office Unavailable | Facility $1979.25 |
| El Centro | Office Unavailable | Facility $1675.06 |
| Fort Lauderdale | Office Unavailable | Facility $1961.40 |
| Fort Worth | Office Unavailable | Facility $1710.58 |
| Fresno | Office Unavailable | Facility $1673.72 |
| Galveston | Office Unavailable | Facility $1700.83 |
| Hanford-Corcoran | Office Unavailable | Facility $1673.72 |
| Hawaii, Guam | Office Unavailable | Facility $1683.23 |
| Houston | Office Unavailable | Facility $1846.89 |
| Idaho | Office Unavailable | Facility $1568.51 |
| Indiana | Office Unavailable | Facility $1574.77 |
| Iowa | Office Unavailable | Facility $1546.26 |
| Kansas | Office Unavailable | Facility $1570.40 |
| Kentucky | Office Unavailable | Facility $1673.97 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $1768.33 |
| Madera | Office Unavailable | Facility $1673.72 |
| Manhattan | Office Unavailable | Facility $2030.45 |
| Merced | Office Unavailable | Facility $1673.72 |
| Metropolitan Boston | Office Unavailable | Facility $1832.95 |
| Metropolitan Kansas City | Office Unavailable | Facility $1710.42 |
| Metropolitan Philadelphia | Office Unavailable | Facility $1828.00 |
| Metropolitan St. Louis | Office Unavailable | Facility $1722.26 |
| Miami | Office Unavailable | Facility $2164.73 |
| Minnesota | Office Unavailable | Facility $1564.77 |
| Mississippi | Office Unavailable | Facility $1615.90 |
| Modesto | Office Unavailable | Facility $1673.72 |
| Montana** | Office Unavailable | Facility $1740.32 |
| Napa | Office Unavailable | Facility $1804.21 |
| Nebraska | Office Unavailable | Facility $1544.39 |
| Nevada** | Office Unavailable | Facility $1696.74 |
| New Hampshire | Office Unavailable | Facility $1723.87 |
| New Mexico | Office Unavailable | Facility $1761.36 |
| New Orleans | Office Unavailable | Facility $1753.59 |
| North Carolina | Office Unavailable | Facility $1617.94 |
| North Dakota** | Office Unavailable | Facility $1582.53 |
| Northern Nj | Office Unavailable | Facility $1890.51 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $2113.44 |
| Ohio | Office Unavailable | Facility $1708.32 |
| Oklahoma | Office Unavailable | Facility $1638.78 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $1743.02 |
| Portland | Office Unavailable | Facility $1734.06 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $1883.10 |
| Puerto Rico | Office Unavailable | Facility $1741.24 |
| Queens | Office Unavailable | Facility $2000.04 |
| Redding | Office Unavailable | Facility $1673.72 |
| Rest Of California | Office Unavailable | Facility $1673.72 |
| Rest Of Florida | Office Unavailable | Facility $1857.39 |
| Rest Of Georgia | Office Unavailable | Facility $1749.00 |
| Rest Of Illinois | Office Unavailable | Facility $1856.25 |
| Rest Of Louisiana | Office Unavailable | Facility $1683.84 |
| Rest Of Maine | Office Unavailable | Facility $1608.23 |
| Rest Of Maryland | Office Unavailable | Facility $1734.54 |
| Rest Of Massachusetts | Office Unavailable | Facility $1725.08 |
| Rest Of Michigan | Office Unavailable | Facility $1740.57 |
| Rest Of Missouri | Office Unavailable | Facility $1678.94 |
| Rest Of New Jersey | Office Unavailable | Facility $1846.40 |
| Rest Of New York | Office Unavailable | Facility $1641.77 |
| Rest Of Oregon | Office Unavailable | Facility $1660.10 |
| Rest Of Pennsylvania | Office Unavailable | Facility $1693.52 |
| Rest Of Texas | Office Unavailable | Facility $1694.68 |
| Rest Of Washington | Office Unavailable | Facility $1712.26 |
| Rhode Island | Office Unavailable | Facility $1745.66 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $1759.29 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $1720.86 |
| Salinas | Office Unavailable | Facility $1713.89 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $1729.16 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $1862.24 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $1853.17 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $1911.65 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $1874.60 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $1690.86 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $1725.45 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $1713.45 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $1740.31 |
| Seattle (King Cnty) | Office Unavailable | Facility $1836.32 |
| South Carolina | Office Unavailable | Facility $1670.59 |
| South Dakota** | Office Unavailable | Facility $1563.87 |
| Southern Maine | Office Unavailable | Facility $1638.92 |
| Stockton | Office Unavailable | Facility $1673.72 |
| Suburban Chicago | Office Unavailable | Facility $1964.91 |
| Tennessee | Office Unavailable | Facility $1581.19 |
| Utah | Office Unavailable | Facility $1689.76 |
| Vallejo | Office Unavailable | Facility $1791.15 |
| Vermont | Office Unavailable | Facility $1605.20 |
| Virgin Islands | Office Unavailable | Facility $1741.24 |
| Virginia | Office Unavailable | Facility $1655.72 |
| Visalia | Office Unavailable | Facility $1673.72 |
| West Virginia | Office Unavailable | Facility $1803.53 |
| Wisconsin | Office Unavailable | Facility $1539.67 |
| Wyoming** | Office Unavailable | Facility $1671.55 |
| Yuba City | Office Unavailable | Facility $1673.72 |
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33266 billing questions
How does this differ from 33265?
33266 is for an extensive atrial ablation lesion set. Use 33265 when the surgical ablation is limited rather than extensive.
How does this differ from 33255?
33266 identifies an endoscopic approach. Code 33255 is the extensive atrial ablation alternative for a non-endoscopic approach without cardiopulmonary bypass.
What operative details support reporting 33266?
The operative report should describe the extensive atrial ablation performed, the endoscopic access, and whether cardiopulmonary bypass was used.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
Should modifier 50 be appended?
No. The code describes an atrial procedure for which modifier 50 is inappropriate.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care through 90 days after surgery.
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.
3,88633263,,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
3,89233269,,Excl laa thrscp any method,A,,13.95,6.42,NA,6.42,,3.46,23.83,23.83,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00