Billing code 33018: Pericardial drainageMedicare rate & RVUs in Iowa
Percutaneous drainage of pericardial fluid with imaging guidance for patients age 0–5 or any age with a congenital cardiac anomaly.
CMS doesn’t publish an office rate for 33018 in Iowa.
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 33018 covers
A physician accesses the pericardial space through the skin and drains fluid, using imaging guidance when performed to guide access. Typical situations include a clinically significant pericardial effusion or tamponade in an infant or young child, or drainage in a patient of any age with a congenital cardiac anomaly. Cardiologists and other physicians experienced in pericardial procedures perform this service in hospital or procedural settings.
Report 33018 for percutaneous pericardial drainage when the patient is age 0–5 or has a congenital cardiac anomaly; that distinction separates it from 33017. Imaging guidance is included when performed. Documentation should support the patient’s age or congenital cardiac history, the clinical indication, percutaneous access, and drainage performed. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. In a session with multiple procedures, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate for this single pericardial target. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are 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.
33018 in Iowa
| Payment locality | Office | Facility |
|---|---|---|
| Iowa | Unavailable | $223.12 |
How the 33018 rate is calculated
Each of 33018’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 · 33018
RVUs × geographic indexes × conversion factor
Work5.27
5.27 RVUs× 1.000 GPCI
Practice expense0.99
0.99 RVUs× 1.000 GPCI
Malpractice1.27
1.27 RVUs× 1.000 GPCI
Adjusted RVUs
7.5300
Conversion factor
$33.4009
Medicare rate
$251.51
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33018
The CMS indicators that decide how 33018 is paid alongside other services.
CMS payment indicators · 33018
Pericardial drainage
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
33018 without 51 · national facility
$251.51
Pericardial drainage
33018-51 · Second procedure: 50%
$125.76
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%).
33018 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 33017Pericardial drainage
- Both describe percutaneous pericardial drainage. Choose 33018 for age 0–5 or any age with a congenital cardiac anomaly; 33017 is for age 6 or older without one.
- 33019Pericardial drainage
- 33019 specifies drainage with insertion of an indwelling catheter. For 33018, the patient must meet the age or congenital-anomaly criterion and the service must match that code.
- 33016Pericardiocentesis
- 33016 is the pericardiocentesis code. Use 33018 for the specified patient group when the service is percutaneous pericardial drainage.
- 33025Pericardial window
- 33025 is a surgical pericardial-window procedure; 33018 is percutaneous drainage.
33018 billing questions
How does 33018 differ from 33017?
Use 33018 for patients age 0–5 or patients of any age with a congenital cardiac anomaly. Code 33017 is for patients age 6 or older without a congenital cardiac anomaly.
When is 33019 the better fit?
33019 describes percutaneous pericardial drainage with insertion of an indwelling catheter. Distinguish it by the catheter placement documented for the service.
Can imaging guidance be billed separately?
Imaging guidance is included in 33018 when performed. Do not separately report guidance for the same drainage service.
How is 33018 distinguished from 33016?
33016 describes pericardiocentesis, while 33018 describes percutaneous pericardial drainage for the specified age or congenital-anomaly group. Select based on the service performed and the applicable code definition.
Can modifier 50 or an assistant-at-surgery claim be used?
Modifier 50 is inappropriate for this pericardial procedure. CMS does not pay an assistant at surgery for 33018.
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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