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Billing code 33523: CABG graftingMedicare rate & RVUs

This add-on represents six or more venous grafts during coronary bypass that also uses arterial grafting, reported with the arterial CABG primary code.

CMS RVU26DEffective Oct 1, 2026109 payment localities32 Medicare services in 2024

Medicare pays $756.53 for 33523 nationally in a facility.

Medicare rate · 33523

CABG grafting

Swap in your local Medicare rate.

Work RVUs
15.68
Total RVUs
22.65
Global days
ZZZ

National rate · 2026

$756.53

Facility setting, before claim adjustments.

See every locality for 33523 → · 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 33523 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 33523 covers

During coronary artery bypass surgery, the surgeon uses venous conduits alongside arterial conduits to route blood around obstructed coronary arteries. This code represents the venous-graft portion when six or more venous grafts are used. It applies to CABG performed by a cardiac surgeon in an operating room. The primary arterial CABG code identifies the number of arterial grafts, while 33523 captures the venous-graft count.

Select the code from the operative report’s documented conduit and graft counts, rather than simply the number of coronary targets or distal connections. Report 33523 only with the appropriate primary arterial CABG code, 33533–33536, selected according to the arterial-graft count. The operative note should identify the conduits and support six or more venous grafts. CMS classifies 33523 as an add-on code: it is billed only with a primary procedure, and its payment falls within that procedure’s global period.

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 33523 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

33523 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$688.73
Alaska*Unavailable$969.15
ArizonaUnavailable$735.16
ArkansasUnavailable$680.62
AtlantaUnavailable$785.00
AustinUnavailable$749.54
BakersfieldUnavailable$727.83
Baltimore/Surr. CntysUnavailable$802.45
BeaumontUnavailable$737.96
BrazoriaUnavailable$732.20

33523 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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Local rates. Clear comparisons.

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View every state and territory as a table
33523 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 33523 rate is calculated

Each of 33523’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 · 33523

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 15.68Practice expense 3.22Malpractice 3.75

22.6500 adjusted RVUs×$33.4009 conversion factor=$756.53

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

Payment rules and modifiers for 33523

The CMS indicators that decide how 33523 is paid alongside other services.

CMS payment indicators · 33523

CABG grafting

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 80 · payment effect

With and without the modifier

33523 without 80 · national facility

$756.53

CABG grafting

33523-80 · Assistant: 16%

$121.04

A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.

When to use modifier 80

33523 compared with similar codes

Compare codes

33523 vs 33522 vs 33516 vs 33536: national Medicare rates

Swap in your local Medicare rate.

  • 33523
    CABG grafting · 15.68 wRVU
    —
  • 33522
    Coronary bypass · 13.79 wRVU
    —
  • 33516
    Coronary bypass · 48.52 wRVU
    —
  • 33536
    CABG · 47.22 wRVU
    —

How to choose

33522Coronary bypass
Use 33522 when the CABG includes arterial grafting and five venous grafts. 33523 represents six or more venous grafts.
33516Coronary bypass
33516 represents six or more venous grafts for CABG without arterial grafting; 33523 is for the arterial-and-venous combination.
33536CABG
33536 represents the arterial-graft portion when four or more arterial grafts are used. 33523 represents six or more venous grafts and is reported as an add-on.

Codes related to 33523

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

Codes related to 33523
CodeHow it relatesNational office range
Primary code
33533Arterial CABGPrimary CABG code for one arterial graft; paired when that is the arterial-graft count.No office rate
33534Arterial CABGPrimary CABG code for two arterial grafts.No office rate
33535Arterial CABGPrimary CABG code for three arterial grafts.No office rate
33536CABGPrimary CABG code for four or more arterial grafts.No office rate
Same family
33522Coronary bypassRepresents five venous grafts with arterial grafting.No office rate
Used instead
33516Coronary bypassRepresents six or more venous grafts when CABG does not include arterial grafting.No office rate

33523 billing questions

Which primary CABG code is reported with 33523?

Report it with the appropriate arterial CABG code from 33533–33536. The primary code reflects the arterial-graft count.

Does six or more refer to the arterial or venous grafts?

It refers to the venous grafts. The arterial-graft count is represented by the primary CABG code.

Can 33523 be reported by itself?

No. It is an add-on code billed only with a primary procedure, and CMS payment is within that procedure’s global period.

How does 33523 differ from 33516?

33523 represents six or more venous grafts in CABG that also uses arterial grafting. 33516 is for six or more venous grafts without arterial grafting.

What documentation supports 33523?

The operative report should identify the arterial and venous conduits and document six or more venous grafts.

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 33523PPRRVU2026_Oct_nonQPP.csv, line 3,995 (RVU26D)

Open CMS sourceHow we calculate rates

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