Billing code 33690: Pulmonary artery bandingMedicare rate & RVUs in Illinois
Reports surgical placement of a pulmonary artery band to limit excessive pulmonary blood flow, commonly as palliation for congenital heart disease.
CMS doesn’t publish an office rate for 33690 in Illinois.
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 33690 covers
A surgeon places a constricting band around the pulmonary artery to reduce blood flow to the lungs. This is a palliative operation used in selected congenital heart conditions with excessive pulmonary blood flow, including situations in which a child needs protection from ongoing pulmonary overcirculation before another cardiac operation. The procedure is performed in an operating room by a congenital cardiac surgeon, generally in a hospital setting.
Report the code for banding the pulmonary artery; distinguish it from code 33620, which describes bands on both the right and left pulmonary arteries. The operative report should identify the treated vessel and document the band placement and clinical reason for limiting pulmonary flow. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are paid at 50%. Modifier 50 is inappropriate. Assistant-at-surgery services 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 33690 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $1,377.78 |
| East St. Louis | Unavailable | $1,298.60 |
| Rest Of Illinois | Unavailable | $1,221.15 |
| Suburban Chicago | Unavailable | $1,297.78 |
How the 33690 rate is calculated
Each of 33690’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 · 33690
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 19.85Practice expense 9.76Malpractice 4.99
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 33690
33690 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 33690
Pulmonary artery banding
| 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 · 33690
Pulmonary artery banding
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
33690 without 51 · national facility
$1,155.67
Pulmonary artery banding
33690-51 · Second procedure: 50%
$577.84
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%).
33690 compared with similar codes
Compare codes
33690 vs 33620 vs 33688 vs 33677: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 33620Pulmonary artery banding
- Use 33620 when the operation applies bands to both the right and left pulmonary arteries; 33690 describes pulmonary artery banding without that bilateral specification.
- 33688VSD closure
- 33688 describes closure of a single ventricular septal defect with removal of a pulmonary artery band, rather than placement of a band.
- 33677VSD repair
- 33677 describes closure of multiple ventricular septal defects with removal of a pulmonary artery band; it is not the band-placement service.
33690 billing questions
How does 33690 differ from 33620?
33690 is for banding the pulmonary artery. Code 33620 describes applying bands to both the right and left pulmonary arteries, so use the operative report to identify which vessels were treated.
Should modifier 50 be added for bilateral banding?
No. CMS identifies bilateral adjustment as inappropriate for this code; the separate bilateral pulmonary artery banding code is 33620.
What documentation supports reporting 33690?
Document the congenital condition and reason for restricting pulmonary blood flow, the vessel treated, and the surgical work performed to place the band.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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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