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Billing code 33504: Coronary repairMedicare rate & RVUs

Surgical graft-based repair of a coronary artery arising from the pulmonary artery, reported when the operative approach uses coronary artery grafting.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $1,396.83 for 33504 nationally in a facility.

Medicare rate · 33504

Coronary repair

Swap in your local Medicare rate.

Work RVUs
24.82
Total RVUs
41.82
Global days
090

National rate · 2026

$1,396.83

Facility setting, before claim adjustments.

See every locality for 33504 → · 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 33504 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 33504 covers

This major cardiac operation corrects an anomalous coronary artery that originates from the pulmonary artery by using a graft-based reconstruction. It is typically performed by a cardiothoracic surgeon in a hospital operating room, often for a congenital coronary anomaly such as anomalous left coronary artery from the pulmonary artery. The operative report should identify the anomalous origin and describe the graft-based repair performed.

Select this code when the documented technique matches this graft-based repair, rather than a tunnel, pulmonary artery translocation, or intramural-course repair. 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 other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this anatomy. 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 33504 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

33504 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,261.34
Alaska*Unavailable$1,740.94
ArizonaUnavailable$1,355.63
ArkansasUnavailable$1,244.95
AtlantaUnavailable$1,447.02
AustinUnavailable$1,395.51
BakersfieldUnavailable$1,365.42
Baltimore/Surr. CntysUnavailable$1,485.78
BeaumontUnavailable$1,349.69
BrazoriaUnavailable$1,354.30

33504 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
33504 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 33504 rate is calculated

Each of 33504’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 · 33504

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 24.82Practice expense 10.75Malpractice 6.25

41.8200 adjusted RVUs×$33.4009 conversion factor=$1,396.83

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

Payment rules and modifiers for 33504

33504 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 33504

Coronary repair

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 · 33504

Coronary repair

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

33504 without 51 · national facility

$1,396.83

Coronary repair

33504-51 · Second procedure: 50%

$698.42

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

33504 compared with similar codes

Compare codes

33504 vs 33503 vs 33505 vs 33506 vs 33507: national Medicare rates

Swap in your local Medicare rate.

  • 33504
    Coronary repair · 24.82 wRVU
    —
  • 33503
    Coronary repair · 21.95 wRVU
    —
  • 33505
    Coronary repair · 37.44 wRVU
    —
  • 33506
    Coronary repair · 36.9 wRVU
    —
  • 33507
    Coronary repair · 30.62 wRVU
    —

How to choose

33503Coronary repair
Both are in the anomalous coronary artery repair family. Use the code matching the specific repair technique documented in the operative report.
33505Coronary repair
33505 identifies repair by creating an intrapulmonary tunnel; 33504 is for the graft-based approach.
33506Coronary repair
33506 identifies repair by pulmonary artery translocation, rather than the graft-based repair reported with 33504.
33507Coronary repair
33507 addresses an anomalous aortic coronary origin with an intramural course; 33504 concerns a coronary artery arising from the pulmonary artery.

Codes related to 33504

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

Codes related to 33504
CodeHow it relatesNational office range
Same family
33503Coronary repairNeighboring code in the anomalous coronary artery repair family; distinguish by the operative technique.No office rate
Used instead
33505Coronary repairUsed for correction of the anomaly by creating an intrapulmonary tunnel.No office rate
33506Coronary repairUsed when correction is performed by pulmonary artery translocation.No office rate
33507Coronary repairDescribes repair directed at an anomalous aortic coronary origin with an intramural course.No office rate

33504 billing questions

What documentation supports reporting 33504?

The operative report should establish the anomalous coronary origin and describe the graft-based repair. The documented technique should distinguish this service from a tunnel, translocation, or intramural-course repair.

How does 33504 differ from 33505 or 33506?

Those codes identify different repair approaches: creation of an intrapulmonary tunnel for 33505 and pulmonary artery translocation for 33506. Follow the technique documented in the operative report.

Is modifier 50 appropriate?

No. The anatomy and descriptor make bilateral adjustment inappropriate for this service.

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. Related routine postoperative care during that period is not separately reported as an additional service.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, while team surgery is not permitted.

What happens when another procedure is performed in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction, with payment at 50%.

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 33504PPRRVU2026_Oct_nonQPP.csv, line 3,976 (RVU26D)

Open CMS sourceHow we calculate rates

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