No office rate
Use 33509 for endoscopic upper-extremity artery harvest and 33508 for endoscopic vein harvest. The conduit harvested determines which harvest code describes the service.
On this page
CMS RVU26D · Effective 2026-10-01
33509 Artery harvest Medicare reimbursement rates in Hawaii
Reports endoscopic procurement of one upper-extremity artery segment as a conduit for coronary artery bypass surgery. Compare 33509 office and facility rates across CMS payment localities in Hawaii.
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 33509 in Hawaii?
Hawaii 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
$149.62
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 33509: Endoscopic upper-extremity artery harvest
Reports endoscopic procurement of one upper-extremity artery segment as a conduit for coronary artery bypass surgery.
This add-on represents endoscopic harvest of one upper-extremity artery segment, typically the radial artery, for use as a coronary bypass conduit. The surgeon or surgical team performs the harvest during the operative episode for CABG, usually in a hospital operating room. The endoscopic approach uses small access incisions to free and retrieve the artery segment for grafting.
Report 33509 with an eligible primary CABG procedure; it is not submitted as a standalone service. The operative report should identify the upper-extremity artery, the segment harvested, the endoscopic technique, and its intended use for bypass grafting. The primary CABG code reflects the bypass procedure and graft configuration, while 33509 captures this separate harvest work. CMS treats this as an add-on code paid within the primary procedure’s global period.
CMS billing rules for 33509
- 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 RVU3.26 · 69%
- Practice expense (office) RVU0.66 · 14%
- Malpractice RVU0.81 · 17%
2.6K
Medicare services in 2024 · #2274 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.
33509 compared with similar codes
Office rates for Hawaii, from the same CMS release.
No office rate
33510 reports a primary CABG procedure using a single venous graft configuration; 33509 reports endoscopic harvest of one upper-extremity artery segment.
No office rate
33533 reports a primary CABG procedure using a single arterial graft. 33509 captures endoscopic procurement of an upper-extremity artery segment as an add-on.
Compare 33509 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
$149.62
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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 33509 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
3,981
- Code
- 33509
- Physician work
- 3.26
- Practice expense
- 0.66
- Malpractice
- 0.81
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.26 | × 1.000 | 3.2600 |
| Practice expense | 0.66 | × 1.137 | 0.7504 |
| Malpractice | 0.81 | × 0.579 | 0.4690 |
| Total RVUs | 4.4794 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$149.62
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.26 | 1 |
| Practice expense | 0.66 | 1.137 |
| Malpractice | 0.81 | 0.579 |
(3.26 × 1 + 0.66 × 1.137 + 0.81 × 0.579) × $33.4009 = $149.62
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.
33509 billing questions
Can 33509 be reported by itself?
No. It is an add-on code and must be reported with a primary CABG procedure.
How is 33509 different from 33508?
33509 is for endoscopic harvest of an upper-extremity artery segment; 33508 describes endoscopic vein harvest.
Does 33509 replace the CABG procedure code?
No. Report the appropriate primary CABG code for the bypass procedure, and report 33509 for the endoscopic artery harvest when supported.
What documentation supports reporting 33509?
The operative report should identify the upper-extremity artery harvested, the single segment, the endoscopic method, and its use as a CABG conduit.
How many segments does this code represent?
The code describes one segment. The operative documentation should support the segment harvested and its role in the bypass 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.
3,97833506,,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
3,98433511,,Cabg vein two,A,,37.49,12.97,NA,12.97,,9.26,59.72,59.72,0,090,0.09,0.84,0.07,2,0,2,0,0,9,,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