No office rate
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.
On this page
CMS RVU26D · Effective 2026-10-01
33018 Pericardial drainage Medicare reimbursement rates in Kentucky
Percutaneous drainage of pericardial fluid with imaging guidance for patients age 0–5 or any age with a congenital cardiac anomaly. Compare 33018 office and facility rates across CMS payment localities in Kentucky.
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 33018 in Kentucky?
Kentucky 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
$244.23
1 of 1 localities have a supported rate.
Payment area: Kentucky
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.
Cardiology procedure
About 33018: Percutaneous pericardial drainage, young child or anomaly
Percutaneous drainage of pericardial fluid with imaging guidance for patients age 0–5 or any age with a congenital cardiac anomaly.
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.
CMS billing rules for 33018
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.27 · 70%
- Practice expense (office) RVU0.99 · 13%
- Malpractice RVU1.27 · 17%
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 compared with similar codes
Office rates for Kentucky, from the same CMS release.
No office rate
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.
No office rate
33016 is the pericardiocentesis code. Use 33018 for the specified patient group when the service is percutaneous pericardial drainage.
No office rate
33025 is a surgical pericardial-window procedure; 33018 is percutaneous drainage.
Compare 33018 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
Kentucky →
Office / nonfacility
Unavailable
Facility
$244.23
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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 33018 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
3,816
- Code
- 33018
- Physician work
- 5.27
- Practice expense
- 0.99
- Malpractice
- 1.27
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.27 | × 1.000 | 5.2700 |
| Practice expense | 0.99 | × 0.889 | 0.8801 |
| Malpractice | 1.27 | × 0.915 | 1.1621 |
| Total RVUs | 7.3122 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kentucky$244.23
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.27 | 1 |
| Practice expense | 0.99 | 0.889 |
| Malpractice | 1.27 | 0.915 |
(5.27 × 1 + 0.99 × 0.889 + 1.27 × 0.915) × $33.4009 = $244.23
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.
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 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.
3,8133300F,,Ajcc stage docd b/4 thxpy,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
3,81433016,,Pericardiocentesis w/imaging,A,,4.29,0.83,NA,0.83,,0.99,6.11,6.11,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,81533017,,Prcrd drg 6yr+ w/o cgen car,A,,4.50,0.87,NA,0.87,,1.04,6.41,6.41,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,81633018,,Prcrd drg 0-5yr or w/anomly,A,,5.27,0.99,NA,0.99,,1.27,7.53,7.53,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,81733019,,Perq prcrd drg insj cath ct,A,,4.18,0.68,NA,0.68,,0.51,5.37,5.37,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,8183301F,,Cancer stage docd metast,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
3,81933020,,Incision of heart sac,A,,13.95,6.10,NA,6.10,,3.41,23.46,23.46,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631