No office rate
Use 33766 when the superior vena cava-to-pulmonary artery shunt serves one lung; this code is for a shunt serving both lungs.
On this page
CMS RVU26D · Effective 2026-10-01
33767 Cavopulmonary shunt Medicare reimbursement rates in Delaware
Reports congenital heart surgery connecting superior vena caval blood flow to the pulmonary arteries serving both lungs, commonly as single-ventricle palliation. Compare 33767 office and facility rates across CMS payment localities in Delaware.
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 33767 in Delaware?
Delaware 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
$1318.52
1 of 1 localities have a supported rate.
Payment area: Delaware
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 heart surgery
About 33767: Superior vena cava to both lungs shunt
Reports congenital heart surgery connecting superior vena caval blood flow to the pulmonary arteries serving both lungs, commonly as single-ventricle palliation.
A congenital cardiac surgeon creates a pathway from the superior vena cava to the pulmonary arteries so venous blood flows to both lungs. This is commonly a bidirectional Glenn-type operation in staged palliation for selected patients with single-ventricle physiology. It is performed in an operating room, generally by a congenital heart surgery team.
Choose this code when the operative report supports a superior vena cava-to-pulmonary artery shunt serving both lungs; the one-lung version is a different code. Documentation should identify the vessels connected and the extent of the shunt. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, the highest-valued is paid in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team-surgery payment is not permitted.
CMS billing rules for 33767
- 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 RVU24.67 · 62%
- Practice expense (office) RVU9.21 · 23%
- Malpractice RVU6.21 · 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.
33767 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
33750 describes a shunt from the subclavian artery to the pulmonary artery. This code connects the superior vena cava to the pulmonary arteries.
No office rate
33764 describes a central shunt with a prosthetic graft. This code describes a cavopulmonary shunt serving both lungs.
Compare 33767 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
Delaware →
Office / nonfacility
Unavailable
Facility
$1318.52
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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 33767 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
4,057
- Code
- 33767
- Physician work
- 24.67
- Practice expense
- 9.21
- Malpractice
- 6.21
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 24.67 | × 1.005 | 24.7934 |
| Practice expense | 9.21 | × 0.988 | 9.0995 |
| Malpractice | 6.21 | × 0.899 | 5.5828 |
| Total RVUs | 39.4756 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$1318.52
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 24.67 | 1.005 |
| Practice expense | 9.21 | 0.988 |
| Malpractice | 6.21 | 0.899 |
(24.67 × 1.005 + 9.21 × 0.988 + 6.21 × 0.899) × $33.4009 = $1318.52
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.
33767 billing questions
How does this differ from 33766?
33767 describes the superior vena cava-to-pulmonary artery shunt serving both lungs. Use 33766 when the documented shunt serves one lung.
Should modifier 50 be appended because both lungs are involved?
No. The bilateral anatomy is built into this code, and CMS identifies modifier 50 as inappropriate.
What operative documentation supports this code?
The operative report should identify the superior vena cava and pulmonary artery connections and show that the shunt serves both lungs.
How are multiple procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team-surgery payment is not permitted.
Does the code include related postoperative care?
Yes. Its 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
4,05433762,,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
4,06033770,,Rpr tga w/o surg enlgmnt vsd,A,,38.09,10.96,NA,10.96,,9.61,58.66,58.66,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503