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CMS RVU26D · Effective 2026-10-01

33606 Cardiac anastomosis Medicare reimbursement rates in Idaho

Reports an operative connection between a pulmonary artery and the aorta to increase pulmonary blood flow in selected congenital heart conditions. Compare 33606 office and facility rates across CMS payment localities in Idaho.

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 33606 in Idaho?

Idaho 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

$1509.78

1 of 1 localities have a supported rate.

Payment area: Idaho

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.

Find 33606 in your payment locality →

Congenital cardiac surgery

About 33606: Pulmonary artery-to-aorta anastomosis

Reports an operative connection between a pulmonary artery and the aorta to increase pulmonary blood flow in selected congenital heart conditions.

This open congenital heart operation creates a connection between a pulmonary artery and the aorta to direct systemic blood into the pulmonary circulation. It may be used as palliation for selected cyanotic congenital heart defects when pulmonary blood flow is inadequate. A congenital cardiac surgeon typically performs the procedure in a hospital operating room; the operative report should identify the vessels connected and the specific repair performed.

Report 33606 when the documented operation matches this direct arterial connection, rather than a differently configured systemic-to-pulmonary shunt or a repair of the underlying defect. The operative note should support the indication, anatomy, and work performed, and identify any other cardiac procedures done during the same session. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation. Modifier 50 is not appropriate for this anatomy, and team-surgery billing is not permitted.

CMS billing rules for 33606

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 RVU30.74 · 61%
  • Practice expense (office) RVU11.74 · 23%
  • Malpractice RVU7.74 · 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.

33606 compared with similar codes

Office rates for Idaho, from the same CMS release.

33750

Systemic-to-pulmonary shunt

Subclavian artery connection

No office rate

33750 describes a subclavian-to-pulmonary artery shunt. Use 33606 for the pulmonary artery-to-aorta anastomosis documented in the operative report.

33755

Systemic-pulmonary shunt

Ascending aorta origin

No office rate

33755 identifies a central systemic-to-pulmonary shunt. Compare its defined configuration with the direct arterial anastomosis documented for 33606.

33762

Systemic-to-pulmonary shunt

Potts-Smith route

No office rate

33762 describes another systemic-to-pulmonary shunt configuration. Select the code that matches the vessels and technique recorded by the surgeon.

Compare 33606 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

Office and facility base rates · shared scale starting at $0

  • Idaho →

    Office / nonfacility

    Unavailable

    Facility

    $1509.78

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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 33606 in Idaho.

PPRRVU2026_Oct_nonQPP.csv

4,010

Code
33606
Physician work
30.74
Practice expense
11.74
Malpractice
7.74

GPCI2026.csv

47

Locality
Idaho
Physician work
1.000
Practice expense
0.920
Malpractice
0.473
Facility calculation for 33606 in Idaho
ComponentRVULocality factorAdjusted
Physician work30.74× 1.00030.7400
Practice expense11.74× 0.92010.8008
Malpractice7.74× 0.4733.6610
Total RVUs45.2018
Conversion factor× 33.4009

Facility rate, Idaho$1509.78

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.
Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work30.741
Practice expense11.740.92
Malpractice7.740.473

(30.74 × 1 + 11.74 × 0.92 + 7.74 × 0.473) × $33.4009 = $1509.78

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.

33606 billing questions

How is 33606 distinguished from a systemic-to-pulmonary shunt code?

Choose 33606 when the operative report supports this direct pulmonary artery-to-aorta anastomosis. Other shunt codes describe different configurations, such as a subclavian-to-pulmonary artery connection.

What documentation supports reporting 33606?

The operative report should identify the congenital condition, the pulmonary artery and aortic anatomy, and the connection created. It should also describe any additional cardiac procedures performed during the session.

Can modifier 50 be used for this service?

No. The anatomy is not reported as a paired bilateral service, so modifier 50 is inappropriate.

Can an assistant surgeon or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, and team-surgery billing is not permitted for this service.

How does the multiple-procedure reduction affect 33606?

For procedures performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction.

What care is included in the global period?

The 90-day global period includes the day-before preoperative visit and 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.

RVUs for 33606PPRRVU2026_Oct_nonQPP.csv, line 4,010 (RVU26D)
Geographic factors for IdahoGPCI2026.csv, line 47 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet