No office rate
Both codes represent venous grafting with arterial CABG. Choose 33517 for one venous graft and 33518 for two.
On this page
CMS RVU26D · Effective 2026-10-01
33518 CABG grafts Medicare reimbursement rates
Add-on reporting for coronary bypass surgery using two venous grafts together with one or more arterial grafts. Compare 33518 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 33518?
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 33518 pays more and less
Cardiac surgery
About 33518: Coronary bypass with two venous grafts
Add-on reporting for coronary bypass surgery using two venous grafts together with one or more arterial grafts.
This add-on represents the venous-graft portion of coronary artery bypass surgery when the operation also uses an arterial graft. A cardiac surgeon typically performs the bypass in a hospital operating room, using venous conduit such as saphenous vein to route blood around coronary artery blockages alongside an arterial conduit such as an internal mammary artery. The code is selected for two venous grafts; it does not represent two total grafts or the arterial graft count.
Report 33518 with the primary arterial CABG code that reflects the number of arterial grafts. The operative report should identify the arterial and venous conduits and document the number of each used. As an add-on, 33518 is billed only with a primary procedure and is paid within that procedure’s global period; it is not a stand-alone CABG report. The venous graft count determines this add-on level, while the arterial graft count determines the primary code.
CMS billing rules for 33518
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU7.73 · 69%
- Practice expense (office) RVU1.55 · 14%
- Malpractice RVU1.91 · 17%
32.7K
Medicare services in 2024 · #939 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.
33518 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
Both are mixed arterial-and-venous CABG add-ons. Choose 33519 when three venous grafts are documented rather than two.
No office rate
33511 represents two venous grafts without the mixed arterial-and-venous coding structure. Use 33518 when arterial grafting is also performed and the primary arterial CABG code is reported.
No office rate
33533 is the primary CABG code for one arterial graft. It does not capture the two venous grafts represented by add-on code 33518.
See how rates vary across the country
33518 · 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 33518 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 $339.60 |
| Alaska* | Office Unavailable | Facility $477.57 |
| Arizona | Office Unavailable | Facility $362.96 |
| Arkansas | Office Unavailable | Facility $335.52 |
| Atlanta | Office Unavailable | Facility $388.18 |
| Austin | Office Unavailable | Facility $370.00 |
| Bakersfield | Office Unavailable | Facility $358.69 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $396.79 |
| Beaumont | Office Unavailable | Facility $364.57 |
| Brazoria | Office Unavailable | Facility $361.32 |
| Chicago | Office Unavailable | Facility $458.44 |
| Chico | Office Unavailable | Facility $353.51 |
| Colorado | Office Unavailable | Facility $366.20 |
| Connecticut | Office Unavailable | Facility $396.30 |
| Dallas | Office Unavailable | Facility $366.81 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $404.12 |
| Delaware | Office Unavailable | Facility $367.98 |
| Detroit | Office Unavailable | Facility $415.71 |
| East St. Louis | Office Unavailable | Facility $434.30 |
| El Centro | Office Unavailable | Facility $353.83 |
| Fort Lauderdale | Office Unavailable | Facility $425.98 |
| Fort Worth | Office Unavailable | Facility $367.13 |
| Fresno | Office Unavailable | Facility $353.51 |
| Galveston | Office Unavailable | Facility $364.49 |
| Hanford-Corcoran | Office Unavailable | Facility $353.51 |
| Hawaii, Guam | Office Unavailable | Facility $353.99 |
| Houston | Office Unavailable | Facility $399.45 |
| Idaho | Office Unavailable | Facility $335.99 |
| Indiana | Office Unavailable | Facility $337.19 |
| Iowa | Office Unavailable | Facility $330.89 |
| Kansas | Office Unavailable | Facility $337.14 |
| Kentucky | Office Unavailable | Facility $362.59 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $372.38 |
| Madera | Office Unavailable | Facility $353.51 |
| Manhattan | Office Unavailable | Facility $436.05 |
| Merced | Office Unavailable | Facility $353.51 |
| Metropolitan Boston | Office Unavailable | Facility $387.37 |
| Metropolitan Kansas City | Office Unavailable | Facility $369.13 |
| Metropolitan Philadelphia | Office Unavailable | Facility $392.84 |
| Metropolitan St. Louis | Office Unavailable | Facility $371.40 |
| Miami | Office Unavailable | Facility $473.42 |
| Minnesota | Office Unavailable | Facility $330.35 |
| Mississippi | Office Unavailable | Facility $349.91 |
| Modesto | Office Unavailable | Facility $353.51 |
| Montana** | Office Unavailable | Facility $373.63 |
| Napa | Office Unavailable | Facility $375.10 |
| Nebraska | Office Unavailable | Facility $330.09 |
| Nevada** | Office Unavailable | Facility $363.15 |
| New Hampshire | Office Unavailable | Facility $367.90 |
| New Mexico | Office Unavailable | Facility $382.28 |
| New Orleans | Office Unavailable | Facility $379.38 |
| North Carolina | Office Unavailable | Facility $347.26 |
| North Dakota** | Office Unavailable | Facility $335.86 |
| Northern Nj | Office Unavailable | Facility $402.64 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $454.74 |
| Ohio | Office Unavailable | Facility $369.76 |
| Oklahoma | Office Unavailable | Facility $353.99 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $366.36 |
| Portland | Office Unavailable | Facility $367.30 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $403.69 |
| Puerto Rico | Office Unavailable | Facility $373.37 |
| Queens | Office Unavailable | Facility $427.90 |
| Redding | Office Unavailable | Facility $353.51 |
| Rest Of California | Office Unavailable | Facility $353.51 |
| Rest Of Florida | Office Unavailable | Facility $403.57 |
| Rest Of Georgia | Office Unavailable | Facility $380.41 |
| Rest Of Illinois | Office Unavailable | Facility $405.17 |
| Rest Of Louisiana | Office Unavailable | Facility $365.12 |
| Rest Of Maine | Office Unavailable | Facility $345.50 |
| Rest Of Maryland | Office Unavailable | Facility $371.73 |
| Rest Of Massachusetts | Office Unavailable | Facility $367.68 |
| Rest Of Michigan | Office Unavailable | Facility $377.48 |
| Rest Of Missouri | Office Unavailable | Facility $364.95 |
| Rest Of New Jersey | Office Unavailable | Facility $395.03 |
| Rest Of New York | Office Unavailable | Facility $352.22 |
| Rest Of Oregon | Office Unavailable | Facility $354.60 |
| Rest Of Pennsylvania | Office Unavailable | Facility $366.00 |
| Rest Of Texas | Office Unavailable | Facility $364.93 |
| Rest Of Washington | Office Unavailable | Facility $364.61 |
| Rhode Island | Office Unavailable | Facility $373.48 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $374.00 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $361.89 |
| Salinas | Office Unavailable | Facility $360.39 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $362.43 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $385.00 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $382.83 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $395.44 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $386.57 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $355.74 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $360.71 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $359.98 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $363.70 |
| Seattle (King Cnty) | Office Unavailable | Facility $386.74 |
| South Carolina | Office Unavailable | Facility $360.25 |
| South Dakota** | Office Unavailable | Facility $331.40 |
| Southern Maine | Office Unavailable | Facility $349.75 |
| Stockton | Office Unavailable | Facility $353.51 |
| Suburban Chicago | Office Unavailable | Facility $426.21 |
| Tennessee | Office Unavailable | Facility $339.51 |
| Utah | Office Unavailable | Facility $364.14 |
| Vallejo | Office Unavailable | Facility $371.97 |
| Vermont | Office Unavailable | Facility $341.72 |
| Virgin Islands | Office Unavailable | Facility $373.37 |
| Virginia | Office Unavailable | Facility $354.12 |
| Visalia | Office Unavailable | Facility $353.51 |
| West Virginia | Office Unavailable | Facility $394.47 |
| Wisconsin | Office Unavailable | Facility $327.44 |
| Wyoming** | Office Unavailable | Facility $357.17 |
| Yuba City | Office Unavailable | Facility $353.51 |
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33518 billing questions
Does 33518 mean two total bypass grafts?
No. It represents two venous grafts used with arterial grafting. The primary arterial CABG code reflects the arterial graft count.
Which primary code is reported with 33518?
Report the arterial CABG code for the number of arterial grafts, such as 33533 for one arterial graft or 33534 for two.
How does 33518 differ from 33511?
33518 is for two venous grafts used with arterial grafting. 33511 represents two venous grafts without the arterial-graft combination represented by 33518.
What documentation supports the two-graft level?
The operative report should identify the graft types and document two venous grafts, along with the arterial grafting that supports the primary CABG code.
Can 33518 be reported by itself?
No. It is an add-on code reported with the primary arterial CABG procedure and is paid within that procedure’s global period.
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.
3,98733514,,Cabg vein five,A,,46.88,15.27,NA,15.27,,11.27,73.42,73.42,0,090,0.09,0.84,0.07,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,98833516,,Cabg vein six or more,A,,48.52,15.86,NA,15.86,,11.66,76.04,76.04,0,090,0.09,0.84,0.07,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,98933517,,Cabg artery-vein single,A,,3.52,0.71,NA,0.71,,0.87,5.10,5.10,0,ZZZ,0.00,0.00,0.00,0,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,99033518,,Cabg artery-vein two,A,,7.73,1.55,NA,1.55,,1.91,11.19,11.19,0,ZZZ,0.00,0.00,0.00,0,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,99133519,,Cabg artery-vein three,A,,10.23,2.04,NA,2.04,,2.52,14.79,14.79,0,ZZZ,0.00,0.00,0.00,0,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,9923351F,,Neg scrn dep symp by deptool,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
3,99333521,,Cabg artery-vein four,A,,12.28,2.45,NA,2.45,,3.03,17.76,17.76,0,ZZZ,0.00,0.00,0.00,0,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00