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Billing code 33745: Intracardiac shuntMedicare rate & RVUs

Report this code for transcatheter creation of the first intracardiac shunt to manage a congenital cardiac anomaly, with imaging guidance included when performed.

CMS RVU26DEffective Oct 1, 2026109 payment localities18 Medicare services in 2024

Medicare pays $929.21 for 33745 nationally in a facility.

Medicare rate · 33745

Intracardiac shunt

Swap in your local Medicare rate.

Work RVUs
19.5
Total RVUs
27.82
Global days
000

National rate · 2026

$929.21

Facility setting, before claim adjustments.

See every locality for 33745 → · 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 33745 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 33745 covers

A congenital interventional cardiologist creates an intentional blood-flow pathway within the heart using a transcatheter approach to address a congenital cardiac anomaly. The service is generally performed in a hospital catheterization laboratory, with imaging guidance included when performed. This code identifies the first shunt created; it is distinct from a transcatheter atrial septostomy and from an extracardiac surgical shunt between a systemic artery and the pulmonary artery.

Report the first shunt under 33745 and use 33746 for each additional shunt when supported by the procedure performed. The operative or catheterization report should establish the congenital anomaly, the shunt created, and whether additional shunts were created. The code has a 0-day global period, so same-day preoperative and postoperative care is included. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeons and team surgery are 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 33745 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

33745 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$846.17
Alaska*Unavailable$1,192.59
ArizonaUnavailable$902.93
ArkansasUnavailable$836.26
AtlantaUnavailable$964.53
AustinUnavailable$919.75
BakersfieldUnavailable$892.14
Baltimore/Surr. CntysUnavailable$985.56
BeaumontUnavailable$907.17
BrazoriaUnavailable$898.94

33745 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.

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
33745 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 33745 rate is calculated

Each of 33745’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 · 33745

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 19.50Practice expense 3.64Malpractice 4.68

27.8200 adjusted RVUs×$33.4009 conversion factor=$929.21

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

Payment rules and modifiers for 33745

The CMS indicators that decide how 33745 is paid alongside other services.

CMS payment indicators · 33745

Intracardiac shunt

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is 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)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

33745 without 51 · national facility

$929.21

Intracardiac shunt

33745-51 · Second procedure: 50%

$464.61

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

33745 compared with similar codes

Compare codes

33745 vs 33746 vs 33741 vs 33750: national Medicare rates

Swap in your local Medicare rate.

  • 33745
    Intracardiac shunt · 19.5 wRVU
    —
  • 33746
    Intracardiac shunt · 7.8 wRVU
    —
  • 33741
    Atrial septostomy · 13.65 wRVU
    —
  • 33750
    Systemic-to-pulmonary shunt · 21.66 wRVU
    —

How to choose

33746Intracardiac shunt
33745 is for the first shunt. Use 33746 for each additional shunt created during the procedure when documented.
33741Atrial septostomy
33741 describes transcatheter atrial septostomy for a congenital cardiac anomaly. Choose 33745 when the service creates an intracardiac shunt rather than performing atrial septostomy.
33750Systemic-to-pulmonary shunt
33750 describes a surgical shunt from the subclavian artery to the pulmonary artery. It is not the transcatheter intracardiac shunt service reported with 33745.

Codes related to 33745

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

Codes related to 33745
CodeHow it relatesNational office range
Add-on codes
33746Intracardiac shuntAdd-on code for each additional intracardiac shunt created after the first.No office rate
Used instead
33741Atrial septostomyDescribes transcatheter atrial septostomy for a congenital cardiac anomaly, rather than intracardiac shunt creation.No office rate
33750Systemic-to-pulmonary shuntDescribes a surgical shunt from the subclavian artery to the pulmonary artery, not a transcatheter intracardiac shunt.No office rate

33745 billing questions

When should 33745 be reported instead of 33741?

Use 33745 for creation of an intracardiac shunt. Code 33741 describes transcatheter atrial septostomy for a congenital cardiac anomaly; select based on the procedure actually performed.

How is a second shunt reported?

Report 33745 for the first shunt and 33746 for each additional shunt created, when the procedure documentation supports the additional service.

Is imaging guidance separately reported?

Imaging guidance is included when performed as part of the service described by 33745; do not separately report it as though it were outside this procedure.

Can modifier 50 be used for bilateral work?

No. Modifier 50 is inappropriate for this code because the descriptor or anatomy does not support a bilateral adjustment.

How does the 0-day global period affect same-day care?

Same-day preoperative and postoperative care is included in the procedure. The code has a 0-day global period.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeons and team surgery are not permitted for this code.

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 33745PPRRVU2026_Oct_nonQPP.csv, line 4,049 (RVU26D)

Open CMS sourceHow we calculate rates

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