Billing code 33505: Coronary repairMedicare rate & RVUs in Guam
Reports surgical creation of an intrapulmonary tunnel to route an anomalous coronary artery arising from the pulmonary artery toward the aorta.
CMS doesn’t publish an office rate for 33505 in Guam.
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 33505 covers
A congenital cardiac surgeon uses this operation to redirect blood flow when a coronary artery arises abnormally from the pulmonary artery. In the Takeuchi procedure, the surgeon creates a tunnel within the pulmonary artery to connect the anomalous coronary opening to the aorta. The operative report should identify the anomalous origin and describe construction of the intrapulmonary tunnel; the service is performed as open cardiac surgery.
Select this code when the documented repair uses the intrapulmonary tunnel technique, rather than direct coronary reimplantation or a bypass-based repair. The 90-day global period includes 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 multiple-procedure reduction. Modifier 50 is inappropriate for this code. 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.
33505 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $1,811.15 |
How the 33505 rate is calculated
Each of 33505’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 · 33505
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 37.44Practice expense 9.96Malpractice 9.43
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 33505
33505 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33505
Coronary repair
| 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 · 33505
Coronary repair
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
33505 without 51 · national facility
$1,898.17
Coronary repair
33505-51 · Second procedure: 50%
$949.09
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%).
33505 compared with similar codes
Compare codes
33505 vs 33502 vs 33503 vs 33506 vs 33507: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 33502Coronary repair
- 33502 describes direct aortic implantation of the anomalous coronary artery; 33505 is the tunnel-based Takeuchi repair.
- 33503Coronary repair
- 33503 describes a ligation-and-bypass approach, while 33505 creates an intrapulmonary tunnel.
- 33506Coronary repair
- 33506 addresses an anomalous coronary artery arising from the aorta and uses ostial translocation, rather than routing a pulmonary-origin artery through a tunnel.
- 33507Coronary repair
- 33507 treats an anomalous aortic coronary origin by unroofing an intramural segment; 33505 treats a pulmonary-origin anomaly with an intrapulmonary tunnel.
33505 billing questions
When is this code chosen instead of 33502?
Use this code for repair by creating an intrapulmonary tunnel. Code 33502 describes direct aortic implantation of the anomalous coronary artery.
How does this differ from 33503?
This code represents the tunnel technique. Code 33503 describes repair using coronary artery ligation and bypass grafting.
Can modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for this code.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be allowed. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What documentation supports reporting the tunnel repair?
The operative report should establish that the coronary artery arises from the pulmonary artery and describe creation of the intrapulmonary tunnel.
What postoperative care is included?
The 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 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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