No office rate
Choose 33257 for limited atrial ablation performed with another open cardiac procedure. Code 33258 is for the more extensive lesion set.
On this page
CMS RVU26D · Effective 2026-10-01
33258 in Madera
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$620.99
Base rate per service
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.
Cardiac surgery
About 33258: Extensive atrial ablation during cardiac surgery
Add-on extensive atrial ablation performed during another open cardiac operation to treat atrial fibrillation, without cardiopulmonary bypass.
Code 33258 represents an extensive set of surgical lesions in atrial tissue to interrupt pathways sustaining atrial fibrillation. A cardiac surgeon may perform it during another open cardiac operation, such as valve surgery or coronary artery bypass, using the operative exposure. It describes an adjunct to that operation, not a standalone ablation session, and distinguishes an extensive lesion set from a limited one.
Report it only with an eligible primary open cardiac procedure; CMS treats the add-on service within that procedure’s global period. The operative report should support the atrial fibrillation treatment, extent of the lesion set, concurrent cardiac operation, and absence of cardiopulmonary bypass. Use the extensive add-on code for this situation; a limited lesion set or use of bypass points to a different code in the family.
CMS billing rules for 33258
- 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 RVU10.73 · 56%
- Practice expense (office) RVU5.75 · 30%
- Malpractice RVU2.57 · 13%
65
Medicare services in 2024 · #5186 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.
33258 compared with similar codes
Office rates for Madera, from the same CMS release.
No office rate
Both describe extensive atrial ablation as an add-on during another open cardiac procedure. Use 33259 when cardiopulmonary bypass is used; 33258 is for cases without bypass.
No office rate
33255 describes extensive surgical atrial ablation without bypass when it is not reported as the add-on during another open cardiac procedure.
No office rate
33266 is the extensive endoscopic approach. Code 33258 describes the open surgical approach without cardiopulmonary bypass.
The same code, a different location
How does Madera compare?
33258 across payment areas
Same release and payment basis · bars start at $0
Madera · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
No comparable rate is available in this setting.
Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Merced
California · 33258
Office
Unavailable
Facility
$620.99
No comparable office rate is available.
Modesto
California · 33258
Office
Unavailable
Facility
$620.99
No comparable office rate is available.
Napa
California · 33258
Office
Unavailable
Facility
$677.71
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 33258
Office
Unavailable
Facility
$648.91
No comparable office rate is available.
Redding
California · 33258
Office
Unavailable
Facility
$620.99
No comparable office rate is available.
Rest Of California
California · 33258
Office
Unavailable
Facility
$620.99
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 33258
Office
Unavailable
Facility
$648.56
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 33258
Office
Unavailable
Facility
$640.66
No comparable office rate is available.
Salinas
California · 33258
Office
Unavailable
Facility
$638.10
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 33258
Office
Unavailable
Facility
$645.37
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 33258
Office
Unavailable
Facility
$702.64
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 33258
Office
Unavailable
Facility
$699.72
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 33258
Office
Unavailable
Facility
$720.77
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 33258
Office
Unavailable
Facility
$708.84
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 33258
Office
Unavailable
Facility
$629.25
No comparable office rate is available.
Santa Cruz-Watsonville
California · 33258
Office
Unavailable
Facility
$645.28
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 33258
Office
Unavailable
Facility
$638.37
No comparable office rate is available.
Santa Rosa-Petaluma
California · 33258
Office
Unavailable
Facility
$651.00
No comparable office rate is available.
Stockton
California · 33258
Office
Unavailable
Facility
$620.99
No comparable office rate is available.
Vallejo
California · 33258
Office
Unavailable
Facility
$673.50
No comparable office rate is available.
Visalia
California · 33258
Office
Unavailable
Facility
$620.99
No comparable office rate is available.
Yuba City
California · 33258
Office
Unavailable
Facility
$620.99
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 33258
Office
Unavailable
Facility
$699.53
No comparable office rate is available.
Miami
Florida · 33258
Office
Unavailable
Facility
$775.41
No comparable office rate is available.
Chicago
Illinois · 33258
Office
Unavailable
Facility
$750.92
No comparable office rate is available.
Manhattan
New York · 33258
Office
Unavailable
Facility
$740.64
No comparable office rate is available.
Alaska*
Alaska · 33258
Office
Unavailable
Facility
$789.42
No comparable office rate is available.
Alabama
Alabama · 33258
Office
Unavailable
Facility
$575.03
No comparable office rate is available.
Arkansas
Arkansas · 33258
Office
Unavailable
Facility
$567.57
No comparable office rate is available.
Arizona
Arizona · 33258
Office
Unavailable
Facility
$617.97
No comparable office rate is available.
Colorado
Colorado · 33258
Office
Unavailable
Facility
$634.08
No comparable office rate is available.
Connecticut
Connecticut · 33258
Office
Unavailable
Facility
$676.27
No comparable office rate is available.
Delaware
Delaware · 33258
Office
Unavailable
Facility
$627.10
No comparable office rate is available.
Fort Lauderdale
Florida · 33258
Office
Unavailable
Facility
$708.14
No comparable office rate is available.
Rest Of Florida
Florida · 33258
Office
Unavailable
Facility
$671.01
No comparable office rate is available.
Atlanta
Georgia · 33258
Office
Unavailable
Facility
$657.69
No comparable office rate is available.
Rest Of Georgia
Georgia · 33258
Office
Unavailable
Facility
$632.03
No comparable office rate is available.
Hawaii, Guam
Hawaii · 33258
Office
Unavailable
Facility
$626.46
No comparable office rate is available.
Iowa
Iowa · 33258
Office
Unavailable
Facility
$568.20
No comparable office rate is available.
Idaho
Idaho · 33258
Office
Unavailable
Facility
$575.68
No comparable office rate is available.
East St. Louis
Illinois · 33258
Office
Unavailable
Facility
$707.96
No comparable office rate is available.
Rest Of Illinois
Illinois · 33258
Office
Unavailable
Facility
$667.91
No comparable office rate is available.
Suburban Chicago
Illinois · 33258
Office
Unavailable
Facility
$710.25
No comparable office rate is available.
Indiana
Indiana · 33258
Office
Unavailable
Facility
$578.15
No comparable office rate is available.
Kansas
Kansas · 33258
Office
Unavailable
Facility
$575.27
No comparable office rate is available.
Kentucky
Kentucky · 33258
Office
Unavailable
Facility
$607.67
No comparable office rate is available.
New Orleans
Louisiana · 33258
Office
Unavailable
Facility
$636.63
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 33258
Office
Unavailable
Facility
$610.60
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 33258
Office
Unavailable
Facility
$678.80
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 33258
Office
Unavailable
Facility
$634.77
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 33258
Office
Unavailable
Facility
$676.39
No comparable office rate is available.
Rest Of Maryland
Maryland · 33258
Office
Unavailable
Facility
$635.14
No comparable office rate is available.
Rest Of Maine
Maine · 33258
Office
Unavailable
Facility
$588.48
No comparable office rate is available.
Southern Maine
Maine · 33258
Office
Unavailable
Facility
$602.88
No comparable office rate is available.
Detroit
Michigan · 33258
Office
Unavailable
Facility
$688.45
No comparable office rate is available.
Rest Of Michigan
Michigan · 33258
Office
Unavailable
Facility
$630.65
No comparable office rate is available.
Minnesota
Minnesota · 33258
Office
Unavailable
Facility
$581.43
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 33258
Office
Unavailable
Facility
$622.60
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 33258
Office
Unavailable
Facility
$627.24
No comparable office rate is available.
Rest Of Missouri
Missouri · 33258
Office
Unavailable
Facility
$607.55
No comparable office rate is available.
Mississippi
Mississippi · 33258
Office
Unavailable
Facility
$587.19
No comparable office rate is available.
Montana**
Montana · 33258
Office
Unavailable
Facility
$636.12
No comparable office rate is available.
North Carolina
North Carolina · 33258
Office
Unavailable
Facility
$592.43
No comparable office rate is available.
North Dakota**
North Dakota · 33258
Office
Unavailable
Facility
$585.30
No comparable office rate is available.
Nebraska
Nebraska · 33258
Office
Unavailable
Facility
$568.11
No comparable office rate is available.
New Hampshire
New Hampshire · 33258
Office
Unavailable
Facility
$633.43
No comparable office rate is available.
Northern Nj
New Jersey · 33258
Office
Unavailable
Facility
$695.43
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 33258
Office
Unavailable
Facility
$676.62
No comparable office rate is available.
New Mexico
New Mexico · 33258
Office
Unavailable
Facility
$637.60
No comparable office rate is available.
Nevada**
Nevada · 33258
Office
Unavailable
Facility
$622.14
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 33258
Office
Unavailable
Facility
$769.09
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 33258
Office
Unavailable
Facility
$688.69
No comparable office rate is available.
Queens
New York · 33258
Office
Unavailable
Facility
$732.12
No comparable office rate is available.
Rest Of New York
New York · 33258
Office
Unavailable
Facility
$601.19
No comparable office rate is available.
Ohio
Ohio · 33258
Office
Unavailable
Facility
$620.27
No comparable office rate is available.
Oklahoma
Oklahoma · 33258
Office
Unavailable
Facility
$596.59
No comparable office rate is available.
Portland
Oregon · 33258
Office
Unavailable
Facility
$641.36
No comparable office rate is available.
Rest Of Oregon
Oregon · 33258
Office
Unavailable
Facility
$610.02
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 33258
Office
Unavailable
Facility
$667.18
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 33258
Office
Unavailable
Facility
$615.82
No comparable office rate is available.
Puerto Rico
Puerto Rico · 33258
Office
Unavailable
Facility
$637.11
No comparable office rate is available.
Rhode Island
Rhode Island · 33258
Office
Unavailable
Facility
$640.16
No comparable office rate is available.
South Carolina
South Carolina · 33258
Office
Unavailable
Facility
$608.81
No comparable office rate is available.
South Dakota**
South Dakota · 33258
Office
Unavailable
Facility
$579.29
No comparable office rate is available.
Tennessee
Tennessee · 33258
Office
Unavailable
Facility
$579.07
No comparable office rate is available.
Austin
Texas · 33258
Office
Unavailable
Facility
$638.36
No comparable office rate is available.
Beaumont
Texas · 33258
Office
Unavailable
Facility
$612.91
No comparable office rate is available.
Brazoria
Texas · 33258
Office
Unavailable
Facility
$618.54
No comparable office rate is available.
Dallas
Texas · 33258
Office
Unavailable
Facility
$626.56
No comparable office rate is available.
Fort Worth
Texas · 33258
Office
Unavailable
Facility
$625.75
No comparable office rate is available.
Galveston
Texas · 33258
Office
Unavailable
Facility
$623.05
No comparable office rate is available.
Houston
Texas · 33258
Office
Unavailable
Facility
$670.09
No comparable office rate is available.
Rest Of Texas
Texas · 33258
Office
Unavailable
Facility
$618.17
No comparable office rate is available.
Utah
Utah · 33258
Office
Unavailable
Facility
$616.01
No comparable office rate is available.
Virginia
Virginia · 33258
Office
Unavailable
Facility
$607.79
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 33258
Office
Unavailable
Facility
$637.11
No comparable office rate is available.
Vermont
Vermont · 33258
Office
Unavailable
Facility
$591.96
No comparable office rate is available.
Rest Of Washington
Washington · 33258
Office
Unavailable
Facility
$630.61
No comparable office rate is available.
Seattle (King Cnty)
Washington · 33258
Office
Unavailable
Facility
$682.09
No comparable office rate is available.
Wisconsin
Wisconsin · 33258
Office
Unavailable
Facility
$568.82
No comparable office rate is available.
West Virginia
West Virginia · 33258
Office
Unavailable
Facility
$648.13
No comparable office rate is available.
Wyoming**
Wyoming · 33258
Office
Unavailable
Facility
$613.97
No comparable office rate is available.
See how rates vary across the country
33258 · 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 |
Where does this rate apply?
Madera is a Medicare payment area. Our Census mapping connects it to 17 cities and communities in California, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 33258 in Madera. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$683.09
$620.99 × 110% = $683.09
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 33258 in Madera.
PPRRVU2026_Oct_nonQPP.csv
3,881
- Code
- 33258
- Physician work
- 10.73
- Practice expense
- 5.75
- Malpractice
- 2.57
GPCI2026.csv
14
- Locality
- Madera
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 10.73 | × 1.017 | 10.9124 |
| Practice expense | 5.75 | × 1.096 | 6.3020 |
| Malpractice | 2.57 | × 0.536 | 1.3775 |
| Total RVUs | 18.5919 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Madera$620.99
Open 33258 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 10.73 | 1.017 |
| Practice expense | 5.75 | 1.096 |
| Malpractice | 2.57 | 0.536 |
(10.73 × 1.017 + 5.75 × 1.096 + 2.57 × 0.536) × $33.4009 = $620.99
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
33258 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $620.99 | RVU26D |
| 2026-07-01 | Not available in this setting | $620.99 | RVU26C |
| 2026-04-01 | Not available in this setting | $620.99 | RVU26B |
| 2026-01-01 | Not available in this setting | $620.99 | RVU26A |
| 2025-10-01 | Not available in this setting | $610.07 | RVU25D |
| 2025-07-01 | Not available in this setting | $610.07 | RVU25C |
| 2025-04-01 | Not available in this setting | $610.07 | RVU25B |
| 2025-01-01 | Not available in this setting | $610.07 | RVU25A |
33258 billing questions
Can 33258 be reported by itself?
No. It is an add-on for extensive atrial ablation performed with another eligible open cardiac procedure, and CMS places it within that primary procedure’s global period.
How does 33258 differ from 33257?
33258 describes an extensive lesion set; 33257 is for limited atrial ablation performed during another open cardiac procedure.
When should 33259 be used instead?
Use 33259 for the extensive add-on when cardiopulmonary bypass is used. Code 33258 is the extensive add-on without bypass.
What documentation supports reporting 33258?
The operative report should establish atrial fibrillation treatment, an extensive atrial lesion set, the concurrent open cardiac operation, and whether cardiopulmonary bypass was used.
Can it accompany valve surgery or bypass surgery?
It may be reported as an add-on when extensive atrial ablation is performed during an eligible open cardiac operation, such as valve surgery or coronary artery bypass.
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.
3,87833255,,Ablate atria w/o bypass ext,A,,28.31,11.34,NA,11.34,,6.77,46.42,46.42,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,87933256,,Ablate atria w/bypass exten,A,,34.03,12.52,NA,12.52,,8.15,54.70,54.70,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,88033257,,Ablate atria lmtd add-on,A,,9.39,5.32,NA,5.32,,2.33,17.04,17.04,0,ZZZ,0.00,0.00,0.00,0,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,88133258,,Ablate atria x10sv add-on,A,,10.73,5.75,NA,5.75,,2.57,19.05,19.05,0,ZZZ,0.00,0.00,0.00,0,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,88233259,,Ablate atria w/bypass add-on,A,,13.79,7.43,NA,7.43,,3.36,24.58,24.58,0,ZZZ,0.00,0.00,0.00,0,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,8833325F,,Preop asses 4 cataract surg,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
3,88433261,,Ablate heart dysrhythm focus,A,,28.20,10.97,NA,10.97,,6.75,45.92,45.92,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1101112,CA,56,FRESNO,1.017,1.096,0.536
1201112,CA,57,HANFORD-CORCORAN,1.017,1.096,0.536
1301182,CA,18,LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY),1.041,1.183,0.664
1401112,CA,58,MADERA,1.017,1.096,0.536
1501112,CA,59,MERCED,1.017,1.096,0.536
1601112,CA,60,MODESTO,1.017,1.096,0.536
1701112,CA,51,NAPA,1.063,1.318,0.508