No office rate
33509 reports endoscopic harvest of an upper-extremity artery for CABG. Use 33508 for endoscopic vein harvest.
On this page
CMS RVU26D · Effective 2026-10-01
33508 Vein harvest Medicare reimbursement rates in Guam
Reports endoscopic procurement of vein for coronary artery bypass surgery as an add-on to a qualifying CABG procedure. Compare 33508 office and facility rates across CMS payment localities in Guam.
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 33508 in Guam?
Guam 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
$13.65
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
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.
Cardiac surgery
About 33508: Endoscopic coronary bypass vein harvest
Reports endoscopic procurement of vein for coronary artery bypass surgery as an add-on to a qualifying CABG procedure.
During coronary artery bypass surgery, this service captures endoscopic procurement of a vein conduit, most often the saphenous vein from the leg, for use in the bypass. The surgeon or another qualified member of the cardiac surgical team works through small incisions using an endoscope to locate, free, and retrieve the conduit. The bypass graft is fashioned and connected as part of the primary operation; 33508 represents the vein-harvest work, not the coronary bypass anastomoses.
Report 33508 as an add-on with an eligible CABG primary procedure when the vein was harvested endoscopically. It may accompany vein-only, combined artery-and-vein, or arterial CABG coding when the operative report supports the qualifying bypass and documents the endoscopic harvest. Do not report it alone. Under the CMS rule for this code, payment falls within the primary procedure's global period. Documentation should identify the harvested conduit and site, the endoscopic approach, and its intended use for coronary revascularization.
CMS billing rules for 33508
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU0.30 · 70%
- Practice expense (office) RVU0.06 · 14%
- Malpractice RVU0.07 · 16%
56.6K
Medicare services in 2024 · #736 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.
33508 compared with similar codes
Office rates for Guam, from the same CMS release.
No office rate
33510 reports a single-vein CABG bypass, not the endoscopic procurement of the vein. 33508 is an add-on when that harvest is performed endoscopically.
No office rate
33517 describes a combined artery-and-vein CABG procedure. It is a primary bypass code; 33508 separately identifies eligible endoscopic vein-harvest work.
No office rate
33533 reports arterial CABG. 33508 identifies endoscopic vein procurement when it is also performed for the bypass.
Compare 33508 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
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$13.65
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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 33508 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
3,980
- Code
- 33508
- Physician work
- 0.30
- Practice expense
- 0.06
- Malpractice
- 0.07
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.30 | × 1.000 | 0.3000 |
| Practice expense | 0.06 | × 1.137 | 0.0682 |
| Malpractice | 0.07 | × 0.579 | 0.0405 |
| Total RVUs | 0.4088 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$13.65
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.3 | 1 |
| Practice expense | 0.06 | 1.137 |
| Malpractice | 0.07 | 0.579 |
(0.3 × 1 + 0.06 × 1.137 + 0.07 × 0.579) × $33.4009 = $13.65
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.
33508 billing questions
Can 33508 be reported by itself?
No. It is an add-on and must be reported with a qualifying primary CABG procedure.
Which CABG procedures can be paired with 33508?
It may be paired with eligible vein-only, combined artery-and-vein, or arterial CABG procedures when the record supports endoscopic vein harvest for the bypass.
How is 33508 different from 33510?
33508 reports the endoscopic harvest of vein; 33510 reports a single-vein coronary bypass. The harvest code supplements the bypass procedure rather than replacing it.
What should the operative report document?
Document the vein and harvest site, the endoscopic approach, and that the conduit was procured for coronary bypass.
How does the CMS global-period rule affect payment?
CMS treats 33508 as an add-on paid within the global period of the primary CABG procedure.
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.
3,97733505,,Repair artery w/tunnel,A,,37.44,9.96,NA,9.96,,9.43,56.83,56.83,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,97833506,,Repair artery translocation,A,,36.90,10.72,NA,10.72,,9.29,56.91,56.91,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,97933507,,Repair art intramural,A,,30.62,9.67,NA,9.67,,7.72,48.01,48.01,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,98033508,,Endoscopic vein harvest,A,,0.30,0.06,NA,0.06,,0.07,0.43,0.43,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,98133509,,Ndsc hrv uxtr art 1 sgm cab,A,,3.26,0.66,NA,0.66,,0.81,4.73,4.73,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,9823350F,,Mammo bx proven malig 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
3,98333510,,Cabg vein single,A,,34.11,11.85,NA,11.85,,8.37,54.33,54.33,0,090,0.09,0.84,0.07,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014