Billing code 33764: Systemic-pulmonary shuntMedicare rate & RVUs

Medicare pays $1,262.22 for 33764 nationally in a facility.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 33764 covers

A congenital cardiac surgeon creates a central connection from the systemic arterial circulation to the pulmonary artery using a prosthetic graft. The shunt provides additional pulmonary blood flow, often as palliation for a cyanotic congenital heart defect with inadequate flow to the lungs. The procedure is performed in an operating room; the operative report should identify the shunt’s origin and insertion and confirm use of a prosthetic graft.

Select this code for the central graft configuration, rather than choosing by the general goal of increasing pulmonary blood flow alone. Document the anatomy and construction so the central route can be distinguished from named subclavian or aortic shunt routes. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued is paid in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; 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 33764 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

33764 rates by state

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

How the 33764 rate is calculated

Each of 33764’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.

Payment rules and modifiers for 33764

33764 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

33764 compared with similar codes

How to choose

33750Systemic-to-pulmonary shunt

Use 33750 when the shunt originates from the subclavian artery. This code describes a central prosthetic-graft configuration.

33755Systemic-pulmonary shunt

33755 identifies an ascending aorta-to-pulmonary artery shunt. Choose this code for the central graft configuration rather than that named route.

33762Systemic-to-pulmonary shunt

33762 identifies a descending aorta-to-pulmonary artery shunt. The central prosthetic-graft configuration is reported with this code.

33766Glenn shunt

33766 is a superior vena cava-to-pulmonary artery shunt for one lung, not a systemic arterial-to-pulmonary artery graft shunt.

Codes related to 33764

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

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

Open CMS sourceHow we calculate rates