No office rate
Use 33766 for a connection serving one lung; 33767 identifies the superior vena cava-to-pulmonary artery shunt serving both lungs.
On this page
CMS RVU26D · Effective 2026-10-01
33766 Glenn shunt Medicare reimbursement rates in California
Reports a congenital heart operation connecting the superior vena cava to the pulmonary artery serving one lung, commonly for staged single-ventricle palliation. Compare 33766 office and facility rates across CMS payment localities in California.
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 33766 in California?
California has 29 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 29 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1209.15–$1383.16
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $174.01 per service.
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.
Where 33766 pays more and less in California
Congenital cardiac surgery
About 33766: Unilateral superior vena cava to pulmonary artery shunt
Reports a congenital heart operation connecting the superior vena cava to the pulmonary artery serving one lung, commonly for staged single-ventricle palliation.
A congenital cardiac surgeon creates a cavopulmonary connection by joining the superior vena cava to the pulmonary artery supplying one lung. This unilateral Glenn-type shunt redirects upper-body venous blood toward that lung and is used in selected congenital heart defects, often as part of staged palliation for single-ventricle physiology. The operative report should establish the vessels joined and that the connection serves one lung.
Select this code when the documented connection is to one lung; the bilateral-lung version is 33767. Record the anatomy, operative work, and clinical indication so the unilateral procedure can be distinguished from other systemic-to-pulmonary shunts. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 33766
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are 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 paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU22.98 · 61%
- Practice expense (office) RVU8.88 · 24%
- Malpractice RVU5.78 · 15%
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.
33766 compared with similar codes
Office rates for California, from the same CMS release.
No office rate
33768 describes a secondary cavopulmonary anastomosis. Choose 33766 when the documented operation is the unilateral superior vena cava-to-pulmonary artery shunt.
No office rate
33750 is a subclavian-to-pulmonary artery shunt; 33766 uses the superior vena cava as the systemic venous connection.
Compare 33766 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.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield | Office Unavailable | Facility $1224.78 |
| Chico | Office Unavailable | Facility $1209.15 |
| El Centro | Office Unavailable | Facility $1210.12 |
| Fresno | Office Unavailable | Facility $1209.15 |
| Hanford-Corcoran | Office Unavailable | Facility $1209.15 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $1278.09 |
| Madera | Office Unavailable | Facility $1209.15 |
| Merced | Office Unavailable | Facility $1209.15 |
| Modesto | Office Unavailable | Facility $1209.15 |
| Napa | Office Unavailable | Facility $1304.90 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $1259.90 |
| Redding | Office Unavailable | Facility $1209.15 |
| Rest Of California | Office Unavailable | Facility $1209.15 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $1271.12 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $1243.61 |
| Salinas | Office Unavailable | Facility $1238.58 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $1249.95 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $1347.29 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $1340.73 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $1383.16 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $1356.32 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $1221.91 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $1247.52 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $1238.36 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $1258.28 |
| Stockton | Office Unavailable | Facility $1209.15 |
| Vallejo | Office Unavailable | Facility $1295.44 |
| Visalia | Office Unavailable | Facility $1209.15 |
| Yuba City | Office Unavailable | Facility $1209.15 |
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33766 billing questions
How does 33766 differ from 33767?
33766 describes a superior vena cava-to-pulmonary artery connection serving one lung. Use 33767 when the connection serves both lungs.
Should modifier 50 be appended for a bilateral operation?
No. CMS identifies bilateral adjustment as inappropriate for this code; the both-lungs procedure is represented by 33767.
What documentation supports reporting 33766?
The operative report should identify the superior vena cava and pulmonary artery joined, establish that the connection serves one lung, and describe the congenital indication.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What happens if other procedures are performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
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.
4,05333755,,Shunt as-aort to pulm art,A,,22.04,10.20,NA,10.20,,5.55,37.79,37.79,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,05433762,,Shunt desc aorta to pulm art,A,,22.04,8.69,NA,8.69,,5.55,36.28,36.28,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,05533764,,Shunt central w/prostc graft,A,,22.04,10.20,NA,10.20,,5.55,37.79,37.79,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,05633766,,Shunt supr v/c p-art 1 lung,A,,22.98,8.88,NA,8.88,,5.78,37.64,37.64,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,05733767,,Shunt supr v/c p-art bth lng,A,,24.67,9.21,NA,9.21,,6.21,40.09,40.09,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,05833768,,Anast cavopulm sec sup v/c,A,,7.80,1.54,NA,1.54,,1.96,11.30,11.30,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,0593376F,,Ajcc brstcncr stage 2 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