No office rate
33745 is for the first shunt. Use 33746 for each additional shunt created during the procedure when documented.
On this page
CMS RVU26D · Effective 2026-10-01
33745 Intracardiac shunt Medicare reimbursement rates in Alabama
Report this code for transcatheter creation of the first intracardiac shunt to manage a congenital cardiac anomaly, with imaging guidance included when performed. Compare 33745 office and facility rates across CMS payment localities in Alabama.
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.
What does Medicare pay for 33745 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$846.17
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Congenital cardiac surgery
About 33745: Transcatheter congenital intracardiac shunt creation
Report this code for transcatheter creation of the first intracardiac shunt to manage a congenital cardiac anomaly, with imaging guidance included when performed.
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.
CMS billing rules for 33745
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU19.50 · 70%
- Practice expense (office) RVU3.64 · 13%
- Malpractice RVU4.68 · 17%
18
Medicare services in 2024 · #5973 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.
33745 compared with similar codes
Office rates for Alabama, from the same CMS release.
No office rate
33741 describes transcatheter atrial septostomy for a congenital cardiac anomaly. Choose 33745 when the service creates an intracardiac shunt rather than performing atrial septostomy.
No office rate
33750 describes a surgical shunt from the subclavian artery to the pulmonary artery. It is not the transcatheter intracardiac shunt service reported with 33745.
Compare 33745 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alabama →
Office / nonfacility
Unavailable
Facility
$846.17
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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 33745 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
4,049
- Code
- 33745
- Physician work
- 19.50
- Practice expense
- 3.64
- Malpractice
- 4.68
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 19.50 | × 1.000 | 19.5000 |
| Practice expense | 3.64 | × 0.875 | 3.1850 |
| Malpractice | 4.68 | × 0.566 | 2.6489 |
| Total RVUs | 25.3339 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Alabama$846.17
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 19.5 | 1 |
| Practice expense | 3.64 | 0.875 |
| Malpractice | 4.68 | 0.566 |
(19.5 × 1 + 3.64 × 0.875 + 4.68 × 0.566) × $33.4009 = $846.17
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.
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 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.
4,04633735,,Revision of heart chamber,A,,21.65,10.12,NA,10.12,,5.45,37.22,37.22,0,090,0.09,0.84,0.07,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,04733736,,Revision of heart chamber,A,,23.71,10.53,NA,10.53,,5.98,40.22,40.22,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,04833741,,Tas congenital car anomal,A,,13.65,2.54,NA,2.54,,3.26,19.45,19.45,0,000,0.00,0.00,0.00,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,04933745,,Tis cgen car anomal 1st shnt,A,,19.50,3.64,NA,3.64,,4.68,27.82,27.82,0,000,0.00,0.00,0.00,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,05033746,,Tis cgen car anomal ea addl,A,,7.80,1.45,NA,1.45,,1.86,11.11,11.11,0,ZZZ,0.00,0.00,0.00,0,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,0513374F,,Ajcc brst cncr stage 1 docd,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
4,05233750,,Shunt subclavian to pulm art,A,,21.66,8.62,NA,8.62,,5.45,35.73,35.73,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515