Billing code 33750: Systemic-to-pulmonary shuntMedicare rate & RVUs in Florida
Reports a palliative congenital heart operation connecting the subclavian artery with a pulmonary artery to increase pulmonary blood flow in selected patients.
CMS doesn’t publish an office rate for 33750 in Florida.
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 9 sections
What 33750 covers
The surgeon creates a connection from the subclavian artery to a pulmonary artery to augment blood flow to the lungs. This palliative operation is used for selected congenital heart conditions with inadequate pulmonary blood flow, including some forms of pulmonary atresia or tetralogy of Fallot. It is generally performed by a congenital cardiothoracic surgeon in an operating room, often for an infant or child awaiting further repair or as part of a staged treatment plan.
Report the procedure when the operative record supports the subclavian-to-pulmonary-artery route; the congenital diagnosis alone does not establish this code. Documentation should identify the vessels connected and describe the shunt performed. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
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 33750 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | Unavailable | $1,344.24 |
| Miami | Unavailable | $1,483.55 |
| Rest Of Florida | Unavailable | $1,272.31 |
How the 33750 rate is calculated
Each of 33750’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 · 33750
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 21.66Practice expense 8.62Malpractice 5.45
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 33750
33750 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33750
Systemic-to-pulmonary shunt
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.84/0.07 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 33750
Systemic-to-pulmonary shunt
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
33750 without 51 · national facility
$1,193.41
Systemic-to-pulmonary shunt
33750-51 · Second procedure: 50%
$596.71
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
33750 compared with similar codes
Compare codes
33750 vs 33755 vs 33762 vs 33764: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 33755Systemic-pulmonary shunt
- Use 33750 for a subclavian-source shunt. Code 33755 describes an aorta-to-pulmonary-artery route.
- 33762Systemic-to-pulmonary shunt
- This code is specific to a subclavian source; 33762 identifies the descending aorta as the source.
- 33764Systemic-pulmonary shunt
- 33764 is for a central shunt with a prosthetic graft. Choose 33750 when the documented shunt uses the subclavian-to-pulmonary-artery route.
33750 billing questions
How is this distinguished from an aorta-to-pulmonary artery shunt?
Select this code when the subclavian artery is the systemic source for the shunt. A shunt originating from the aorta is represented by a different code.
What operative documentation supports this code?
The operative report should identify the subclavian artery and pulmonary artery as the connected vessels and describe the shunt performed.
Can modifier 50 be used for shunts to both lungs?
No. CMS identifies bilateral adjustment as inappropriate for this code. Report the procedure supported by the documented operative anatomy rather than adding modifier 50.
Is an assistant surgeon payable?
CMS indicates that assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care through the 90-day 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
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