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Billing code 33924: Shunt removalMedicare rate & RVUs

Reports removal of a prior systemic-to-pulmonary artery shunt during congenital heart surgery, in addition to the primary operation.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $258.52 for 33924 nationally in a facility.

Medicare rate · 33924

Shunt removal

Swap in your local Medicare rate.

Work RVUs
5.35
Total RVUs
7.74
Global days
ZZZ

National rate · 2026

$258.52

Facility setting, before claim adjustments.

See every locality for 33924 → · 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 33924 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 33924 covers

This service removes a surgically created connection that directs blood from a systemic artery to the pulmonary arteries. A typical example is removal of a prior Blalock-Taussig-type shunt during a later operation to repair congenital heart disease. A congenital cardiac surgeon generally performs the removal in the operating room as part of the larger heart operation; it is not a stand-alone shunt procedure.

Report 33924 only with an eligible primary procedure, such as a pulmonary atresia repair or pulmonary artery unifocalization when the shunt is also removed. The operative report should identify the existing shunt, document its removal, and describe the primary operation performed. CMS treats this as an add-on: payment is included within the primary procedure’s global period. The add-on should not be submitted by itself.

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 33924 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

33924 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$234.82
Alaska*Unavailable$330.23
ArizonaUnavailable$251.03
ArkansasUnavailable$231.99
AtlantaUnavailable$268.55
AustinUnavailable$255.87
BakersfieldUnavailable$247.95
Baltimore/Surr. CntysUnavailable$274.49
BeaumontUnavailable$252.18
BrazoriaUnavailable$249.86

33924 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
33924 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 33924 rate is calculated

Each of 33924’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 · 33924

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 5.35Practice expense 1.06Malpractice 1.33

7.7400 adjusted RVUs×$33.4009 conversion factor=$258.52

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

Payment rules and modifiers for 33924

The CMS indicators that decide how 33924 is paid alongside other services.

CMS payment indicators · 33924

Shunt removal

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)1Permitted with supporting documentation.
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

33924 without 80 · national facility

$258.52

Shunt removal

33924-80 · Assistant: 16%

$41.36

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

When to use modifier 80

33924 compared with similar codes

Compare codes

33924 vs 33920 vs 33922 vs 33925 vs 33926: national Medicare rates

Swap in your local Medicare rate.

  • 33924
    Shunt removal · 5.35 wRVU
    —
  • 33920
    Congenital heart repair · 31.92 wRVU
    —
  • 33922
    Pulmonary artery surgery · 23.61 wRVU
    —
  • 33925
    Pulmonary artery repair · 30.52 wRVU
    —
  • 33926
    Pulmonary artery repair · 43.61 wRVU
    —

How to choose

33920Congenital heart repair
33920 describes the pulmonary atresia repair itself. Code 33924 is additional and applies only when a prior systemic-to-pulmonary shunt is removed during the operation.
33922Pulmonary artery surgery
33922 describes transection of a pulmonary artery for a congenital heart defect; 33924 describes removal of a previously created systemic-to-pulmonary shunt.
33925Pulmonary artery repair
33925 describes pulmonary artery unifocalization without cardiopulmonary bypass. It is a primary reconstructive service, not the shunt-removal work represented by 33924.
33926Pulmonary artery repair
33926 describes pulmonary artery unifocalization with cardiopulmonary bypass. Use 33924 only for additional removal of a prior systemic-to-pulmonary shunt.

Codes related to 33924

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

Codes related to 33924
CodeHow it relatesNational office range
Primary code
33920Congenital heart repairPulmonary atresia repair may be the primary operation when the prior shunt is removed.No office rate
33925Pulmonary artery repairUnifocalization without bypass may be the primary operation when the prior shunt is removed.No office rate
33926Pulmonary artery repairUnifocalization with bypass may be the primary operation when the prior shunt is removed.No office rate

33924 billing questions

Can 33924 be billed by itself?

No. It is an add-on for removal of an existing systemic-to-pulmonary shunt during a primary operation, and must be reported with that operation.

How is 33924 different from 33920?

33920 represents the main repair for pulmonary atresia. Report 33924 in addition only when a prior systemic-to-pulmonary shunt is also removed.

What documentation supports reporting 33924?

The operative note should identify the prior shunt and describe its removal, alongside the primary congenital heart operation.

Is payment for 33924 separate from the primary procedure’s global period?

No. CMS identifies 33924 as an add-on paid within the primary 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 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 33924PPRRVU2026_Oct_nonQPP.csv, line 4,120 (RVU26D)

Open CMS sourceHow we calculate rates

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